Environmental Public Health Commons^™

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

Associations Between Atmospheric Ozone, Pm2.5 And Prevalence Of Diabetes In Georgia, United States, Kingsley A. Kalu, Jingjing Yin, Atin Adhikari

Journal of the Georgia Public Health Association

Objective:

This study examines the association between two air pollutants (PM_2.5 and ozone), and the prevalence of adult diabetes mellitus in relation to various confounding factors.

Methods:

We collected diabetes prevalence data from the 2015 County Health Ranking and Georgia Health Data Hub. A negative binomial regression analysis was conducted to examine the associations between the county-level dependent variable “adult diabetes” (for adults aged> 18 years diagnosed with Type 1 and Type 2 diabetes) and two independent county-level variables: percentage of days ³ NAAQS for ozone and PM_2.5 concentration levels while controlling for confounders.

Results:

At the county …

93rd Annual Georgia Public Health Association Meeting And Conference Report, Jimmie H. Smith Jr, Angela Peden, Patrina L. Bowles

Journal of the Georgia Public Health Association

The 93^rd Annual Meeting and Conference of the Georgia Public Health Association (GPHA) was held in Jekyll Island, Georgia, at the Jekyll Island Convention Center, on May 3-5, 2023. The goal of the 2023 Georgia Public Health Association Annual Meeting and Conference was to assemble emerging public health professionals, current practitioners, academicians, governing entities, and community stakeholders for educational opportunities and networking to support the vision and mission of GPHA.

The theme for the 2023 Georgia Public Health Association Annual Meeting and Conference theme was selected by the GPHA Executive Board during a meeting in the early fall of …

Is The Public Aware Of Water Quality Monitoring And Safety Notifications On Beaches?, Asli Aslan, Jeffery A. Jones, Dziyana Nazaruk, Sibel Zeki

Journal of the Georgia Public Health Association

Recreational water-related activities have important public health benefits, however, pollution at beaches may have serious health risks. Although there is a substantial amount of research and policies in place at federal and state levels, oftentimes these efforts may not be well translated to the public. This paper evaluates the effectiveness of routine water quality monitoring and warning systems in Georgia, USA. A survey was conducted among 238 beachgoers in Georgia, asking about awareness of water quality monitoring and warning signs for beach advisories. Surveys were collected directly at beaches as well as through an online questionnaire. Results show that more …

Comparing Particulate Matter Exposures During Two Work Shifts In A Large University Dining Commons Kitchen, Shalom Emmanuel, Atin Adhikari

Journal of the Georgia Public Health Association

Objective: Cooking emits a huge concentration of indoor air pollutants, including particulate matter (PM). Exposure to PM can lead to long-term adverse respiratory effects among workers engaged in cooking. Only a few studies have measured cooking-related air pollutants in large school cafeterias where young student workers are frequently employed. The objective of this research was to compare stationary exposures to PM from cooking during two work shifts at a very large university dining commons kitchen.

Methods: Number concentrations of PM of varying aerodynamic sizes (1, 2.5, 5, and 10 µm) were measured at the back kitchen, DC grill, and …

Please Romaine Calm! A Multi-Disciplinary Investigation Of A Cyclospora Outbreak Among Hospital Employees, Jocelyn Love Mph, Amber Erickson Drph, Mph, Hope Dishman Mph, Carla Coley Bs, Rehs

Georgia Public Health Association Annual Meeting & Conference

Background

On July 8, 2022, North Central Health District (NCHD) was notified by a local hospital of a possible Cyclospora outbreak among hospital employees. The hospital noted the employees had eaten at the hospital’s cafeteria, particularly the salad bar. An investigation was conducted to test this hypothesis and determine which salad bar ingredients were the cause of illness.

Methods

An electronic survey was shared with all hospital employees through their email distribution system. Employees were asked to complete the survey regardless of illness or exposure history. Lab- confirmed cases were interviewed using the Cyclosporiasis National Hypothesis Generating Questionnaire. Environmental health …

South-Eastern Provider Knowledge Gaps In Rabies Education, Management, And Treatment, Joseph A. Addison, Jeffrey Alexander

Georgia Public Health Association Annual Meeting & Conference

Abstract:

Background. In the United States, when an individual is bitten by an animal there are many levels of care they may seek, including seeing their primary care provider, an urgent care provider, or by going to an emergency room. In any of these settings, it is not unlikely that they may be treated by an advanced practice practitioner (APP). Due to rabies being nearly 100% fatal once symptoms have manifested, it is important to understand the knowledge that APPs have concerning rabies.

Methods. A survey was conducted from April 2022 to August 2022 which evaluated APPs knowledge of rabies …

The Microbial Load On Used Disposable Face Masks: Exploring Sustainable Disinfection Methods, Clara Ray

GS4 Student Scholars Symposium

Face masks have become common-place in public settings since the onset of the global COVID-19 pandemic, with many people choosing to wear masks in order to mitigate the risk of becoming infected with viral or bacterial infections. Two of the most widely-available types of masks are cloth masks, which may be reused if cleaned properly, and disposable surgical masks. Despite the fact that surgical masks are intended for one-time use, many people chose to store and re-wear them. The purpose of this study was to determine the changes in biological contamination on surgical face masks after daily wear and overnight …

Association Between Smoking And Child Mortality Rate In Georgia Counties., Kingsley A. Kalu, Ho-Jui Tung Dr

GS4 Student Scholars Symposium

Association between Smoking and Child Mortality Rate in Georgia Counties.

Background:

Despite the major advances in health care, child mortality is still a major concern in the United States and Georgia included. Studies have shown that smoking (especially secondhand smoke) can cause multiple health problems in children, including mortality.

Objective:

The study objective is to examine the association between smoking and child mortality rate in Georgia counties.

Methods:

This study used data from the 2021 County Health Rankings for Georgia State. The total number of counties analyzed in Georgia was 159. Descriptive statistics and linear regression analyses were conducted to …

Air Pollutant Levels And Asthma Emergency Room Visits In A Highly Populous Us Urban County During 2018-19, Osaremhen Ikhile, Jingjing Yin, Atin Adhikari

Journal of the Georgia Public Health Association

Objective: Air pollutants are linked to asthma exacerbation. The study purpose was to demonstrate an association between air pollutants levels and asthma emergency room (ER) visit trends in a highly populated US urban county in Georgia during 2018-2019.

Methods: Time series analyses were conducted for the variations in daily numbers of children and adult asthma emergency room visits and changes in daily mean PM_2.5, daily mean PM₁₀ concentrations, daily max 1-hour SO₂ concentrations, daily max 1-hour NO₂ concentrations, daily max 8-hour ozone concentrations, and airborne pollen loads for 2018 to 2019 and potential trends were …

Sars-Cov-2 Transmission In Alberta, British Columbia, And Ontario, Canada, December 25, 2019, To December 1, 2020, Isaac Chun-Hai Fung, Yuen Wai Hung, Sylvia Ofori, Kamalich Muniz-Rodriguez, Po-Ying Lai, Gerardo Chowell

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Objective:

This study aimed to investigate coronavirus disease (COVID-19) epidemiology in Alberta, British Columbia, and Ontario, Canada.

Methods:

Using data through December 1, 2020, we estimated time-varying reproduction number, R t , using EpiEstim package in R, and calculated incidence rate ratios (IRR) across the 3 provinces.

Results:

In Ontario, 76% (92 745/121 745) of cases were in Toronto, Peel, York, Ottawa, and Durham; in Alberta, 82% (49 878/61 169) in Calgary and Edmonton; in British Columbia, 90% (31 142/34 699) in Fraser and Vancouver Coastal. Across 3 provinces, R t dropped to ≤ 1 after April. …

Mobilizing Rural Communities To Create Systemic Changes To Reduce Health Disparities, Denise Everson, Amanda Tedrow, Al Parker Edd

National Youth Advocacy & Resilience Conference

USG institutions are creating strategies to enhance community capacity in addressing health inequities, "closing the gap" between suggested optimal development models and helping prepare a visioning masterplan in rural communities.

The Use Of Penalized Regression Analysis To Identify County-Level Demographic And Socioeconomic Variables Predictive Of Increased Covid-19 Cumulative Case Rates In The State Of Georgia, Holly L. Richmond, Joana Tome, Haresh Rochani, Isaac Chun-Hai Fung, Gulzar H. Shah, Jessica S. Schwind

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Systemic inequity concerning the social determinants of health has been known to affect morbidity and mortality for decades. Significant attention has focused on the individual-level demographic and co-morbid factors associated with rates and mortality of COVID-19. However, less attention has been given to the county-level social determinants of health that are the main drivers of health inequities. To identify the degree to which social determinants of health predict COVID-19 cumulative case rates at the county-level in Georgia, we performed a sequential, cross-sectional ecologic analysis using a diverse set of socioeconomic and demographic variables. Lasso regression was used to identify variables …

Severe Acute Respiratory Syndrome Coronavirus 2 Transmission Potential, Iran, 2020, Kamalich Muniz-Rodriguez, Isaac Fung, Shayesteh R. Ferdosi, Sylvia Ofori, Yiseul Lee, Amna Tariq, Gerardo Chowell

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

To determine the transmission potential of severe acute respiratory syndrome coronavirus 2 in Iran in 2020, we estimated the reproduction number as 4.4 (95% CI 3.9–4.9) by using a generalized growth model and 3.5 (95% CI 1.3–8.1) by using epidemic doubling time. The reproduction number decreased to 1.55 after social distancing interventions were implemented.

Sars-Cov-2 Viral And Serological Testing When College Campuses Reopen: Some Practical Considerations, Isaac Chun-Hai Fung, Chi-Ngai Cheung, Andreas Handel

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

The coronavirus disease 2019 (COVID-19) pandemic prompted universities across the United States to close campuses in Spring 2020. Universities are deliberating whether, when, and how they should resume in-person instruction in Fall 2020. In this essay, we discuss some practical considerations for the use of 2 potentially useful control strategies based on testing: (1) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase-polymerase chain reaction (RT-PCR) testing followed by case-patient isolation and quarantine of close contacts, and (2) serological testing followed by an “immune shield” approach, that is, low social distancing requirements for seropositive persons. The isolation of case-patients and …

Epidemiology Of Cancers In Men Who Have Sex With Men (Msm): A Protocol For Umbrella Review Of Systematic Reviews, Manoj Kumar Honaryar, Yelena Tarasenko, Maribel Almonte, Vitaly Smelov

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

While earlier studies on men having sex with men (MSM) tended to examine infection-related cancers, an increasing number of studies have been focusing on effects of sexual orientation on other cancers and social and cultural causes for cancer disparities. As a type of tertiary research, this umbrella review (UR) aims to synthesize findings from existing review studies on the effects of sexual orientation on cancer. Relevant peer-reviewed systematic reviews (SRs) will be identified without date or language restrictions using MEDLINE, Cochrane Database of Systematic Reviews, and the International Prospective Register for Systematic Reviews, among others. The research team members will …

Evaluating The Importation Of Yellow Fever Cases Into China In 2016 And Strategies Used To Prevent And Control The Spread Of The Disease, Chao Li, Dan Li, Shirley Joann Smart, Lei Zhou, Peng Yang, Jianming Ou, Yi He, Ruiqi Ren, Tao Ma, Nijuan Xiang, Haitian Sui, Yali Wang, Jian Zhao, Chaonan Wang, Yeping Wang, Daxin Ni, Isaac Chun-Hai Fung, Dexin Li, Yangmu Huang, Qun Li

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

During the yellow fever epidemic in Angola in 2016, cases of yellow fever were reported in China for the first time. The 11 cases, all Chinese nationals returning from Angola, were identified in March and April 2016, one to two weeks after the peak of the Angolan epidemic. One patient died; the other 10 cases recovered after treatment. This paper reviews the epidemiological characteristics of the 11 yellow fever cases imported into China. It examines case detection and disease control and surveillance, and presents recommendations for further action to prevent additional importation of yellow fever into China.

A Call For Consistency In The Official Naming Of The Disease Caused By Severe Acute Respiratory Syndrome Coronavirus 2 In Non-English Languages, Lu Dong, Zhe Li, Isaac Fung

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

We investigated the adoption of World Health Organization (WHO) naming of COVID-19 into the respective languages among the Group of Twenty (G20) countries, and the variation of COVID-19 naming in the Chinese language across different health authorities. On May 7, 2020, we identified the websites of the national health authorities of the G20 countries to identify naming of COVID-19 in their respective languages, and the websites of the health authorities in mainland China, Hong Kong, Macau, Taiwan and Singapore and identify their Chinese name for COVID-19. Among the G20 nations, Argentina, China, Italy, Japan, Mexico, Saudi Arabia and Turkey do …

Doubling Time Of The Covid-19 Epidemic By Province, China, Kamalich Muniz-Rodriguez, Gerardo Chowell, Chi-Hin Cheung, Dongyu Jia, Po-Ying Lai, Yiseul Lee, Manyun Liu, Sylvia Ofori, Kimberlyn M. Roosa, Lone Simonsen, Cecile Viboud, Isaac Fung

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

In China, the doubling time of the coronavirus disease epidemic by province increased during January 20–February 9, 2020. Doubling time estimates ranged from 1.4 (95% CI 1.2–2.0) days for Hunan Province to 3.1 (95% CI 2.1–4.8) days for Xinjiang Province. The estimate for Hubei Province was 2.5 (95% CI 2.4–2.6) days.

Auspicious Symbols Of Rank And Status, Byron Breedlove, Isaac Fung

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Work published in Emerging Infectious Diseases.

Limited Early Warnings And Public Attention To Coronavirus Disease 2019 In China, January–February, 2020: A Longitudinal Cohort Of Randomly Sampled Weibo Users, Yuner Zhu, King-Wa Fu, Karen A. Grépin, Hai Liang, Isaac Fung

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Objective:

Awareness and attentiveness have implications for the acceptance and adoption of disease prevention and control measures. Social media posts provide a record of the public’s attention to an outbreak. To measure the attention of Chinese netizens to coronavirus disease 2019 (COVID-19), a pre-established nationally representative cohort of Weibo users was searched for COVID-19-related key words in their posts.

Methods:

COVID-19-related posts (N = 1101) were retrieved from a longitudinal cohort of 52 268 randomly sampled Weibo accounts (December 31, 2019–February 12, 2020).

Results:

Attention to COVID-19 was limited prior to China openly acknowledging human-to-human transmission on …

Assessing Hotel Employee Knowledge On Risk Factors And Risk Management Procedures For Microbial Contamination Of Hotel Water Distribution Systems, Brandon Leftwich

College of Graduate Studies: Theses & Dissertations

Background: Compromised hotel water supply lines by neglect or by physical and structural damage can lead to exposure of harmful pathogens to guests and staff. To reduce the risk of having contaminated water in a hotel plumbing system, some facilities may incorporate a water safety plan (WSP). WSPs are not mandatory for hotels in many US states, including the state of Georgia. As such, many hotel personnel are uninformed of WSPs and the precautions to take if their hotel water system is compromised. The purpose of this study was to identify hotel personnel’s knowledge and practices of WSPs through a …

Short-Term Effects Of Ambient Ozone, Pm2. 5, And Meteorological Factors On Covid-19 Confirmed Cases And Deaths In Queens, New York., Atin Adhikari, Jingjing Yin

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

The outbreak of coronavirus disease 2019 (COVID-19), caused by the virus SARS-CoV-2, has been rapidly increasing in the United States. Boroughs of New York City, including Queens county, turn out to be the epicenters of this infection. According to the data provided by the New York State Department of Health, most of the cases of new COVID-19 infections in New York City have been found in the Queens county where 42,023 people have tested positive, and 3221 people have died as of 20 April 2020. Person-to-person transmission and travels were implicated in the initial spread of the outbreaks, but factors …

Molecular Typing Of Rickettsia Akari, Marina E. Eremeeva

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Rickettsia akari is an obligate intracellular bacterium that causes smallpox rickettsia. Rickettsia akari is an atypical member of the rickettsia spotted fever (SFG) group because it circulates in gamasid mites; however, only limited data are available regarding the degree of genetic diversity of R. akari isolates. We examined 13 isolates of R. akari isolated from humans, rodents, and ticks in the United States, the countries of the former USSR, and the former Yugoslavia for the period from 1946 to 2003 for diversity in the composition of tandem repeats (TR) and intergenic regions (IGR). Using the Tandem Repeat Finder software (http://tandem.bu.edu) …

Rickettsialpox – A Rare But Not Extinct Disease: A Review Of The Literature And New Directions, Marina Eremeeva, Kamalich Muniz-Rodriguez

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Smallpox rickettsia is an urban zoonosis caused by Rickettsia akari. To date, R. akari is the only characterized representative of the group of spotted fevers transmitted by the gamasid mite Liponyssoides sanguineus, which is common among peridomic rodents. This disease was first described in New York in 1946, and a few years later a similar outbreak occurred in the Ukrainian SSR. Numerous serological studies and diagnostics of sporadic cases of smallpox rickettsiosis suggest its widespread occurrence on the planet; however, the current geography and incidence of smallpox rickettsiosis is unknown. Smallpox rickettsiosis is characterized by the classic clinical triad of …

Standardized Knowledge And Behavior Of Food-Protection Staff To Help Reduce The Potential For Incidences Of Foodborne Illness, Joshua A. Dufresne

College of Graduate Studies: Theses & Dissertations

Background: Environmental public health has always been at the forefront of issues that affect the health and wellbeing of the general public when it comes to food safety. However, with the workforce moving from one of technological laggards toward faster progress toward new and improved systems in performing food service, the question becomes: What are the needs of the environmental health and food safety workforce, and how does one get there? Logically, another question follows: are our current training programs helping to make a difference in the number of foodborne-illness risk-factor violations being issued?

Purpose: This study was to …

Social Ecological Factors Affecting Substance Abuse In Ghana (West Africa) Using Photovoice, Ahmed Kabore, Evans Afriyie-Gyawu, James Awuah, Andrew R. Hansen, Ashley Walker, Melissa Hester, Moussa Aziz Wonadé Sié, Dhruv Medarametla, Nicolas Meda

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Introduction: substance abuse is an important public health issue affecting West Africa; however, there is currently a dearth of literature on the actions needed to address it. The aim of this study was to assess the risks and protective factors of substance abuse in Ghana, West Africa, using the photovoice method.

Methods: this study recruited and trained 10 participants in recovery from substance abuse and undergoing treatment in the greater Accra region of Ghana on the photovoice methodology. Each participant received a disposable camera to take pictures that represented the risk and protective factors pertinent to substance abuse …

Identification Of Bird-Associated Nonpoint Sources Of Microbial Contamination In Sediments, Savannah D. Mullins

Honors College Theses

Fecal indicator bacteria (FIB), such as Enterococci, are commonly used to monitor the microbial contamination of recreational beach waters based on standards set by the United States Environmental Protection Agency. Sediment and sand may also harbor FIB and reintroduce these bacteria to the water column. Enterococci may be originated from various non-point sources such as humans and wildlife. Recent literature has shown that avian feces also harbor high concentrations of Enterococci. The purpose of this study is identify the relationship between Enterococci and avian-associated markers in sediments. Sediment samples were collected monthly from four sites at Kings Ferry Beach in …

Use Of Complementary And Alternative Medicine Among People With Cardiovascular Diseases In Southeast Georgia, Chimuanya Okoli, Stacy Carswell, Sewuese Akuse, Kelly L. Sullivan

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Background: Heart disease is a leading cause of death in the United States. Proper treatment of patients with cardiovascular disease is essential and can be challenged by non-disclosed use of complementary or alternative treatments. The objective of this study was to assess which demographics were associated with complementary and alternative medicine (CAM) use and if education affects the use of CAM.

Methods: A cross-sectional survey was conducted among a stratified random sample of residents of Southeastern Georgia. Sampling was stratified by urban/rural residence in order to reach sufficient rural residents. Participants that indicated they had been diagnosed with hypertension or …

Quasi-Likelihood Ratio Tests For Homoscedasticity Of Variance In Linear Regression, Lili Yu, Varadan Sevilimedu, Robert Vogel, Hani Samawi

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Two quasi-likelihood ratio tests are proposed for the homoscedasticity assumption in the linear regression models. They require few assumptions than the existing tests. The properties of the tests are investigated through simulation studies. An example is provided to illustrate the usefulness of the new proposed tests.