Public Health Commons^™

Informing Healthcare Operations With Integrated Pathology, Clinical, And Epidemiology Data: Lessons From A Single Institution In Kenya During Covid-19 Waves, Allan Njau, Jemimah Kimeu, Jaimini Gohil, David Nganga

Pathology, East Africa

Pathology, clinical care teams, and public health experts often operate in silos. We hypothesized that large data sets from laboratories when integrated with other healthcare data can provide evidence that can be used to optimize planning for healthcare needs, often driven by health-seeking or delivery behavior. From the hospital information system, we extracted raw data from tests performed from 2019 to 2021, prescription drug usage, and admission patterns from pharmacy and nursing departments during the COVID-19 pandemic in Kenya (March 2020 to December 2021). Proportions and rates were calculated. Regression models were created, and a t-test for differences between …

Statistical Analysis Methods Applied To Early Outpatient Covid-19 Treatment Case Series Data, Eleftherios Gkioulekas, Peter A. Mccullough, Vladimir Zelenko

School of Mathematical & Statistical Sciences Faculty Publications

When confronted with a public health emergency, significant innovative treatment protocols can sometimes be discovered by medical doctors at the front lines based on repurposed medications. We propose a statistical framework for analyzing the case series of patients treated with such new protocols, that enables a comparison with our prior knowledge of expected outcomes, in the absence of treatment. The goal of the proposed methodology is not to provide a precise measurement of treatment efficacy, but to establish the existence of treatment efficacy, in order to facilitate the binary decision of whether the treatment protocol should be adopted on an …

On Epidemiology As Racial-Capitalist (Re)Colonization And Epistemic Violence, Ryan J. Petteway

OHSU-PSU School of Public Health Faculty Publications and Presentations

This commentary reflects upon power-knowledge dynamics and matters of epistemic, procedural, and distributive justice that undergird epidemiological knowledge production related to racial health inequities in the U.S. Grounded in Foucault’s power-knowledge concepts—“objects”, “ritual”, and “the privileged”—and guided by Black feminist philosopher Kristie Dotson’s conceptualization of epistemic violence, it critiques the dominant positivist, reductionist, and extractivist paradigm of epidemiology, interrogating the settler-colonial and racial-capitalist nature of the knowledge production/curation enterprise. The commentary challenges epidemiology’s affinity for epistemological, procedural, and methodological norms that effectively silence/erase community knowledge(s) and nuance in favor of reductionist empirical representations/re-presentations produced by researchers who, often, have never …

Epidemiological Assessment Of Wolbachia-Based Biocontrol For Reduction Of Dengue Morbidity, Olga Vasilieva, Oscar E. Escobar, Hector J. Martinez, Pierre-Alexandre Bliman, Yves Dumont

Biology and Medicine Through Mathematics Conference

No abstract provided.

Determinants Of Domestic Violence Among Women Of Reproductive Age (15-49 Years) In Quetta, Balochistan-A Mixed-Method Protocol, Salman Muhammad Soomar, Sarmad Muhammad Soomar

Department of Emergency Medicine

Background: Worldwide, domestic violence (DV) is a cause of death and disability among women aged 15-49 years. In Pakistan, DV appears in different forms, and only 3.2% of women report any DV. There are various factors associated with DV against women. The data are sparse for the Balochistan province due to the under-reporting and scattered population. This research study aims to determine the factors associated with DV and the types of violence among women of reproductive age. Also, to understand the perspective of community leaders and healthcare workers (HCWs) for developing interventions for DV prevention against women of reproductive age …

Emergency Department Antimicrobial Use In A Low-Resource Setting: Results From A Retrospective Observational Study At A Referral Hospital In Liberia, Sojung Yi, Anu Ramachandran, Lane Epps, Alex Mayah, Taylor W Burkholder, Michael Senyu Jaung, Ahson Haider, Paul Whesseh, John Shakpeh, Kayla Enriquez, Corey Bills

Faculty, Staff and Students Publications

OBJECTIVE: Data on antimicrobial use in low-income and middle-income countries (LMICs) remain limited. In Liberia, the absence of local data impedes surveillance and may lead to suboptimal treatment, injudicious use and resistance against antimicrobials. This study aims to examine antimicrobial prescribing patterns for patients in the emergency department (ED) of a large Liberian public hospital. Secondarily, this prescribing was compared with WHO prescribing indicators.

DESIGN: Retrospective observational study.

SETTING: An adult ED of a large public hospital in Monrovia, Liberia.

PARTICIPANTS: A total of 1082 adult patients (>18 years of age) were recorded in the ED, from 1 January …

Association Of Age-Related Macular Degeneration With Prior Hyperthyroidism And Hypothyroidism: A Case-Control Study, Shih-Han Hung, Sudha Xirasagar, Tung-Mei Tammy Kuang, Wei-Wen Chang, Yen-Fu Cheng, Nai-Wen Kuo, Herng-Ching Lin

Faculty Publications

Prior studies suggest a possible association between thyroid disease and the subsequent development of age-related macular degeneration (AMD), although it remains inconclusive. This study aimed to evaluate the association of AMD with prior hyper-/hypothyroidism based on nationwide population-based data. We retrieved records of the study patients from the National Health Insurance Research Database, 7522 patients with a first-time diagnosis of AMD and 7522 propensity score-matched controls. Multiple logistic regression analyses were performed to explore the association of neovascular AMD with previously diagnosed hyperthyroidism or hypothyroidism. The Chi-square test shows that there was a statistically significant difference in the prevalence of …

Demographic And Regional Trends Of Mortality In Patients With Aortic Dissection In The United States, 1999 To 2019, Salik Nazir, Robert W Ariss, Abdul Mannan Khan Minhas, Rochell Issa, Erin D Michos, Yochai Birnbaum, George V Moukarbel, P Kasi Ramanathan, Hani Jneid

Faculty, Staff and Students Publications

Background Aortic dissection (AoD) is associated with high morbidity and mortality. However, the burden of AoD mortality is not well characterized, and contemporary data and mortality trends in different demographic and geographic subgroups have not been described. Methods and Results Trends in AoD mortality were assessed using a cross-sectional analysis of the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. Crude and age-adjusted mortality rates (AAMR) per 1 million people with associated annual percent changes were determined. Joinpoint regression was used to assess trends in the overall sample and different demographic (sex, race and ethnicity, …

“Pandemias Políticas: The Effects Of Political And Social Instability On Infectious Disease Epidemiology In Latin America"”, Sarah H. Noonan

Senior Theses

This paper seeks to analyze the relationship between political and social unrest and conflict and infectious disease epidemiology in Latin America. An analysis of published literature regarding epidemiological, biomedical, political, and historical content was conducted to highlight potential connections between infectious disease epidemics and sociopolitical conflict in the region. Specific analyses of Smallpox, Venezuelan Equine Encephalitis, Chagas disease, Cholera, Dengue, and COVID-19 were conducted, in an effort to uncover potential causations and context of epidemics of these conditions. Results of this analysis depict a necessity for further research into public health and disease control mechanisms during times of conflict and …

The Impact Of Cannabis And Alcohol Use On The Management Of Type 1 Diabetes Mellitus, Joshua Eric Sellner

Theses and Dissertations

This dissertation sought to contribute to the evidence-base of diabetes management and acute complications associated with alcohol and cannabis use among individuals with Type 1 Diabetes (T1DM). Three interconnected studies were initiated to complete this goal. First, existing literature surrounding the potential consequences of cannabis consumption among individuals with T1DM were summarized within a systematic review. Study results were combined to provide a single measure of association through a meta-analysis. Second, identified associations were further investigated through a cross-sectional study using the SEARCH for Diabetes in Youth data on alcohol and cannabis use on diabetes management and acute complications including …

Exploratory Analysis Of The Associations Between Neonicotinoids And Measures Of Adiposity Among Us Adults: Nhanes 2015–2016, Amruta M. Godbole, Sheniz Moonie, Courtney Coughenour, Cai Zhang, Aimin Chen, Ann M. Vuong

Environmental & Global Health Faculty Research

Background: Toxicology studies suggest that neonicotinoids may be associated with adiposity development via thyroid hormone disruption and increased oxidative stress. Prior epidemiological studies report mixed results for the association between neonicotinoids and adiposity measures.

Objective: To examine the association between detectable concentrations of parent neonicotinoids (imidacloprid, acetamiprid, clothianidin) and neonicotinoid metabolites (5-hydroxy-imidacloprid, N-desmethyl-acetamiprid) with adiposity measures among US adults, and whether sex modifies the associations for neonicotinoid metabolites with adiposity.

Methods: National Health and Nutrition Examination Survey (NHANES) 2015–2016 data was utilized to estimate covariate-adjusted associations between detectable neonicotinoids and fat mass index (FMI), lean mass index (LMI), waist …

Increased Risk Of Major Depressive Disorder Following Tinnitus: A Population-Based Study, Herng-Ching Lin, Sudha Xirasagar Mbbs, Ph.D., Chia-Hui Wang, Yen-Fu Cheng, Tzong-Hann Yang

Faculty Publications

Background and Purpose: In this study, we aimed to evaluate the relationship between tinnitus and a subsequent diagnosis of major depressive disorder (MDD) by studying the incidence of both entities.

Design: A retrospective cohort study.

Methods: Data for this observational follow-up study were retrieved from the Taiwan's National Health Insurance Dataset. A total of 375,272 patients with newly diagnosed tinnitus (study group) were retrieved. The date of first diagnosis of tinnitus was assigned as their index date. Comparison patients were selected by propensity score matching (one per case, n = 375,272 controls) from the same dataset, with their index date …

Clinical Outcomes For Patients With Community-Acquired Pneumonia Are Worse In Those With A History Of Stroke, Pradeepthi Badugu, Dilip Kc, Bibodh Jung Karki, Mahder A. Tella, Vidyulata Salunkhe

The University of Louisville Journal of Respiratory Infections

Background: Stroke is one of the most prevalent neurological diseases in the United States. Community-acquired pneumonia (CAP) is the leading cause of infections in survivors of stroke. There is limited research evaluating the clinical outcomes of CAP in patients with stroke. The objective of this study was to evaluate the clinical characteristics and outcomes of hospitalized patients with CAP and a history of stroke.

Methods: This was a secondary analysis of the University of Louisville Pneumonia Study database. Patients were divided into two groups based on the presence or absence of a history of stroke. Clinical outcomes were length of …

Trends In Premature Mortality From Acute Myocardial Infarction In The United States, 1999 To 2019, Sourbha S. Dani, Ahmad N. Lone, Zulqarnain Javed, Muhammad S. Khan, Muhammad Zia Khan, Edo Kaluski, Salim S. Virani, Michael D. Shapiro, Miguel Cainzos‐Achirica, Khurram Nasir

Office of the Provost

Pagination are not provided by the author/publisher. This work was published before the author joined Aga Khan University.

Relationship Between Early Years’ Activities Of Daily Living And Alzheimer’S Disease Onset, Linyi Fan

Walden Dissertations and Doctoral Studies

A few promising studies have indicated that activities of daily life (ADL) may be a useful way of predicting Alzheimer’s Disease (AD). However, the existing cross-sectional studies fail to show how ADLs in early years predict AD, and how social factors influence health either in addition to or in interaction with individual risk factors. Using a social epidemiology framework, this study examined the relationship between early years’ ADL and the development of AD in later years. This quantitative study included 4,526 participants derived from the Health and Retirement Study (HRS) dataset. The dependent variable was whether the participant has been …

Circus-Specific Extension Of The International Olympic Committee Consensus Statement: Methods For Recording And Reporting Of Epidemiological Data On Injury And Illness In Sport 2020, Stephanie Greenspan, David Munro, Joanna Nicholas, Janine Stubbe, Melanie I. Stuckey, Rogier M. Van Rijn

Research outputs 2022 to 2026

Indepth knowledge of injury and illness epidemiology in circus arts is lacking. Comparing results across studies is difficult due to inconsistent methods and definitions. In 2020, the International Olympic Committee (IOC) consensus group proposed a standard method for recording and reporting epidemiological data on injuries and illnesses in sports and stated that sport-specific extension statements are needed to capture the context of each sport. This is the circus-specific extension to be used with the IOC consensus statement. International circus arts researchers in injury and illness epidemiology and performing arts medicine formed a consensus working group. Consensus statement development included a …

Elucidation Of Novel And Established Campylobacter Species With Clinical And Agricultural Significance Through Phenotypic, Genotypic, And Taxonomic Investigation, Caoimhe Lynch

Theses

Campylobacter spp. are well-established human, veterinary and economic pathogens, with a broad host range spanning from terrestrial and marine mammalian, avian and reptilian hosts. The scope of the study includes novel and notorious species within the genus, with reference to zoonotic agents Campylobacter jejuni and Campylobacter coli - the leading cause of human bacterial gastroenteritis in the EU and Ireland, Campylobacter fetus that represents the most common campylobacter causing bacteraemia and two novel species isolated from pigs not described in the literature previously. C. jejuni and C. coli isolates (n = 350) recovered from broiler caecal and neck skin samples, …

A Retrospective Cohort Study Of Factors Associated With Severity Of Falls In Hospital Patients, Manonita Ghosh, Beverly O’Connell, Ebenezer Afrifa-Yamoah, Sue Kitchen, Linda Coventry

Research outputs 2022 to 2026

Severity of falls in hospital patients are threat to patient safety which can result in a financial burden on the patient’s family and health care services. Both patient specific and environmental and organisational factors are associated with severity of falls in hospital. It is important to continuously analyse the factors associated with severity of fall which can inform the implementation of any fall preventive strategies. This study aims to identify factors associated with the severity of falls in hospitalised adult patients in Western Australia. This study involved a retrospective cohort analysis of inpatient falls records extracted from the hospital’s Clinical …

Mothers' Perceptions Of Their Children's Weight: Opportunity For Health Promotion In Kuwait, Abdullah Al-Taiar, Nawal Alqaoud, Reem Sharaf-Alddin, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Background: Mothers’ perceptions of their children’s weight remain mostly unknown in oil-rich countries of the Middle East.

Aims: To compare maternal perceptions of their children’s weight with actual body weight.

Methods: We used the Kuwait nutritional surveillance data for 5 consecutive years (2015-2019) (N = 5119), which were collected through face-to-face interviews with mothers of children aged 2-5 years attending vaccination centres.

Results: Of the 5119 mothers in the study, 163 (3.18%) and 332 (6.48%) had obese or overweight children, respectively. Among 4624 mothers who had normal weight children, 1350 (29.20%) perceived their children’s weight as …

An Odd-Protocol For Agent-Based Model For The Spread Of Covid-19 In Ireland, Elizabeth Hunter, John D. Kelleher

Reports

No abstract provided.

Maternal Antifungal Use During Pregnancy : A Study Of Prevalence Of Use And The Risk Of Birth Defects, Eleni A. Papadopoulos

Legacy Theses & Dissertations (2009 - 2024)

Fungal infections, especially vulvovaginal candidiasis (VVC), are common among pregnant women. Therefore, it is important to study the effect that antifungal medications may have on the developing fetus. Recent studies have suggested there are positive associations between birth defects and specific oral antifungals. In this dissertation, maternal antifungal use during pregnancy was examined using data from the National Birth Defects Prevention Study (NBDPS). The NBDPS was multi-site, population-based, case-control study and included women with estimated delivery dates during October 1997 through December 2011. It was designed to investigate risk factors associated with more than 30 categories of major birth defects. …

Relationship Between Poverty And Ed Visit Rate (Per 10,000) With Primary Diagnosis Of Asthma Amongst Ohio Counties, Emily Schneider

Scholarship in Medicine - All Papers

Objective: Previous literature have found mixed results regarding poverty as a risk factor for asthma prevalence. More recently, national data obtained from Medicaid has shown that there is no association between poverty and asthma prevalence but has shown an association with asthma-related Emergency Department (ED) visits and hospitalizations. The objective of this study is to determine if this relationship is evident amongst the 88 counties in Ohio. Methods: Pearson correlations were conducted with the following variables: percent in poverty under age 18 and the ED visit rate with a primary diagnosis of asthma amongst children in each Ohio county. This …

Endocrine Disruptors: Challenges And Future Directions In Epidemiologic Research, V. Ho, L. Pelland-St-Pierre, S. Gravel, M. F. Bouchard, M.-A. Verner, F. Labrèche

Études primaires

Public concern about the impact of endocrine disrupting chemicals (EDCs) on both humans and the environment is growing steadily. Epidemiologic research provides key information towards our understanding of the relationship between environmental exposures like EDCs and human health outcomes. Intended for researchers in disciplines complementary to epidemiology, this paper highlights the importance and challenges of epidemiologic research in order to present the key elements pertaining to the design and interpretation of an epidemiologic study on EDCs.

The conduct of observational studies on EDCs derives from a thoughtful research question, which will help determine the subsequent methodological choices surrounding the careful …

Papanicolaou (Pap) Test And Human Papillomavirus (Hpv) Test Adherence: Sexual Violence Victims And Fear Of Retraumatization, Murielle Sighe Ngoumkam

CGU Theses & Dissertations

To include all vulnerable women population who faced barriers to participating in preventive cervical cancer screening, the public health community must better understand the factors that affect their decision for getting Pap and HPV tests. Public health must understand the sexual violence victims, a subgroup of women who faced the onset of trauma and explore their adherence to routine screening. This study investigated whether sexual women with a history of sexual violence (SV), likelihood to get screened for cervical cancer would be impacted given the fear of suffering from secondary trauma during conventional screening procedures. Methods: Knowledge of cervical screening …

Early-Life Farm Exposures And Eczema Among Adults In The Agricultural Lung Health Study, Annah B. Wyss, Thanh T. Hoang, Hilde K. Vindenes, Julie D. White, Sinjini Sikdar, Marie Richards, Laura E. Beane-Freeman, Christine G. Parks, Mikyeong Lee, David M. Umbach, Stephanie J. London

Mathematics & Statistics Faculty Publications

Background

Several studies conducted in Europe have suggested a protective association between early-life farming exposure and childhood eczema or atopic dermatitis; however, few studies have examined associations in adults.

Objectives

We investigated associations between early-life exposures and eczema among 3217 adult farmers and farm spouses (mean age, 62.8 years) in a case–control study nested within an US agricultural cohort.

Methods

We used sampling-weighted logistic regression to estimate odds ratios and 95% confidence intervals for associations between early-life exposures and self-reported doctor-diagnosed eczema (273 cases) and polytomous logistic regression to estimate odds ratios (95% confidence intervals) for a 4-level outcome combining …

Nutritional Status Of Children Living Within Institution-Based Care: A Retrospective Analysis With Funnel Plots And Control Charts For Programme Monitoring, Emily Delacey, Evan Hilberg, Elizabeth Allen, Michael Quiring, Cally J. Tann, Nora Ellen Groce, James Vilus, Ethan A. Bergman, Merzel Demasu-Ay, Hang T. Dam, Marko Kerac

All Faculty Scholarship for the College of Education and Professional Studies

Objectives The aim of this study is to fill a key information gap on the nutrition-related epidemiology of orphaned and vulnerable children living within institution-based care (IBC) across six countries.

Design A retrospective analysis with Shewhart control charts and funnel plots to explore intersite and over time variations in nutritional status.

Setting We conducted a retrospective analysis of records from Holt International’s Child Nutrition Programme from 35 sites in six countries; Mongolia, India, Ethiopia, Vietnam, China and the Philippines.

Participants Deidentified health records from Holt International’s online nutrition screening database included records from 2926 children, 0–18 years old. Data were …

Indicadores De Desigualdad Y Mortalidad Por Enfermedades Cardiometabólicas En Guatemala / Inequality Indicators And Cardiometabolic Diseases Mortality In Guatemala, Alejandro Cerón, Gila Y. Goldstein

Anthropology: Faculty Scholarship

La medición de las desigualdades en salud al interior de los países de ingresos bajos y medios es necesaria para la planificación, monitoreo y evaluación de intervenciones de salud pública, especialmente para problemas que contribuyen altamente a la carga de enfermedad, como las enfermedades cardiometabólicas. El objetivo de este estudio fue caracterizar los patrones de desigualdad de las tasas de mortalidad para las principales causas cardiometabólicas en Guatemala. Se usó datos del Censo Nacional de Población, y estadísticas oficiales de defunción de 2018 para calcular tasas crudas de mortalidad para diabetes (DM), infarto agudo de miocardio (IAM), y accidente cerebrovascular …

Élaboration Du Contenu D’Un Site Web Portant Sur L’Incapacité Et Le Retour Au Travail, Christian Larivière, Iuliana Nastasia, Marc Corbière, Manon Truchon, Daniel Côté, Annie Mathieu, Clermont Dionne, Andrea Gragnano, Patrizia Villotti, Alessia Negrini, André Bussières, Marc-Antoine Busque, Martin Lebeau, Marie-France Coutu

Rapports de recherche scientifique

Le corpus de connaissances portant sur l’incapacité au travail est exhaustif et ne cesse de croître. Toutefois, l’appropriation des connaissances par les différents acteurs de la réadaptation et du retour au travail (RT) n’est pas optimale. Une étape essentielle pour faciliter le transfert de ces connaissances est l’accès rapide à de l’information probante et pertinente, centralisée par l’intermédiaire d’un site Web. À notre connaissance, aucune ressource électronique de ce type n’est accessible, sans frais, aux acteurs du Québec. Afin de pallier cette lacune, cette initiative vise à rassembler l’information scientifiquement valide (données probantes) sur l’incapacité au travail et le RT …

Anal Human Papillomavirus Infection Among Men Who Have Sex With Men And Transgender Women Living With And Without Hiv In Pakistan: Findings From A Cross-Sectional Study, Muslima Ejaz, Soren Andersson, Salma Batool, Tazeen Saeed Ali, Anna Mia Ekström

Community Health Sciences

Objectives: The aim of this study was to determine the prevalence of infection, genotypes and risk factors for human papillomavirus (HPV) among men who have sex with men (MSM) and transgender women living with and without HIV in Pakistan. Anal infection with HPV is very common worldwide among MSM, particularly among MSM living with HIV. The high prevalence of HIV among MSM and male-to-female transgendered individuals in Pakistan is a significant health concern since access to screening and health-seeking is often delayed in this stigmatised key population.
Design: This cross-sectional study was conducted between March 2016 and November 2017.
Participants, …

Iron Homeostasis And Manganese Exposure Occupational Cross-Sectional Study Of A Welder Population, Meredith Robbins

The Journal of Purdue Undergraduate Research

Manganese exposure is a serious occupational health hazard for many welders, smelters, and miners. Manganese exposure may result in Parkinson-like symptoms. It has been hypothesized that altered iron concentrations in the brain could also lead to neurological symptoms similar to what appears in those with chronic exposer to manganese. Therefore, the goal of this project is to explore the relationship between manganese and hepcidin as an indicator of altered iron homeostasis. Population demographics were collected from semi-trailer factory workers in a cross-sectional study via a questionnaire. Demographic information includes age, race, and weight. Toenail clippings and questionnaires were collected on …