Epidemiology Commons^™

Treatment Adherence And Incidence Of Coronary Heart Disease In Type 2 Diabetes Mellitus Patients, Ahmad Sahlan Baniu, Rani Sauriasari, Woro Riyadina, Pradana Soewondo

Kesmas

Previous studies showed that uncontrolled blood sugar and long-term use of several types of antidiabetic could increase the risk of coronary heart disease (CHD). This study aimed to compare the incidence of CHD in type 2 diabetes mellitus (T2DM) patients showing treatment adherence and non-adherence behavior over four years. This was a retrospective cohort study with data sets obtained from the Bogor Cohort Study of Non-Communicable Disease Risk Factors. All study subjects were not diagnosed with CHD at the beginning of the study. The sample was divided into two groups; one had adhered to treatment from health centers and followed …

Local Wisdom Enriching Complementary Feeding Practices During Disaster Situations In Indonesia, Astuti Astuti, Happy Hayati, Fajar Tri Waluyanti, Dessie Wanda

Kesmas

This study aimed to analyze complementary food fulfillment during disaster situations in Indonesia since it frequently experiences natural disasters and young children face unique challenges related to their feeding needs in disaster situations. This qualitative case study based on the Mount Merapi eruption and Sumedang landslide in 2021 collected data using observations, forum group discussions, and in-depth interviews; then, a thematic analysis was conducted. This study involved 17 participants, including Non-governmental Organizations (NGO) activists, health workers, residents involved in making complementary foods, and primary caregivers of children aged 6–24 months. This study found that there were five themes generated from …

Infarct Diameter For Predicting Cognitive Dysfunction In Ischemic Stroke Survivors In West Nusa Tenggara, Indonesia, Herpan Syafii Harahap, Setyawati Asih Putri, Yanna Indrayana, Hasan Amin, Fransisca Ika Mahardika

Kesmas

Cognitive dysfunction is an important consequence of ischemic stroke, which can progress in the first few years and is primarily determined by clinical factors. This study aimed to investigate the clinical determinants of cognitive dysfunction in stroke survivors in West Nusa Tenggara Province, Indonesia. This cross-sectional study assessed 255 ischemic stroke survivors with a mean age of 57.1±9.3 years old and 29–79 years old, recruited consecutively in three main hospitals in West Nusa Tenggara Province between March 2019 and October 2021. Categorical data collected included age, sex, education level, clinical determinants of ischemic stroke, and cognitive status of the patients. …

Determinants Of The Coexistence Dual Form Of Malnutrition In Pairs Of Mother And Child Aged 6 – 59 Months In Bogor District 2019, Maulina Dwi Krismanita, Triyanti Triyanti, Ahmad Syafiq, Trini Sudiarti

Kesmas

The dual form of malnutrition (DFM) is defined as multiple nutritional problems in the same household and time. This study aimed to determine the related factor to DFM incidence in pairs of mothers and children aged 6–59 months in Bogor District in 2019. This cross-sectional study used secondary data on the Nutrition and Health of Babakan Madang Subdistrict Toddlers in 2019 and Nutrition Intake and Stunting of Children Under-Five in Bogor District, West Java Province, involving a total sample of 274 households. The dependent variable in this study was DFM, while the independent variables were maternal age during pregnancy, maternal …

Interprofessional Collaborative Practice And Health Workers Retention At Remote Primary Health Care: Case Study From Nusantara Sehat Team-Based Program, Prastuti Soewondo, Retno Pujisubekti, Ade Widyati Prastyani, Nurul Maretia Rahmayanti

Kesmas

The Nusantara Sehat Team (NST), established in 2015 and consist of multi-professional health workers, implemented to provide comprehensive services at remote primary health cares (PHCs) for two years. This study aimed to explore how the NST leverages the Interprofessional Collaboration (IPC) and its impact on the future career prospects of health workers. Using a qualitative approach, the information was gathered from 48 informants drawn from the current 30 NST recruits and 18 alumni through semi-structured interviews. Of these 48, 20 were clinical practitioners, while the rest were non-clinical health workers. The findings revealed several challenges in promoting collaborative practice, including …

The Influence Of Intrapersonal Constraints On Travel Intention Of People At High Risk From Covid-19 During The New Normal, Dyah Widiyastuti, Ikasari Kusuma Wardhani

Kesmas

Due to the COVID-19 pandemic, tourism constraints have created a challenge for inclusive tourism, especially for older people and people with comorbidities. This study examined intrapersonal constraints’ effect on the travel intentions of people facing fewer opportunities for tourism due to the COVID-19 pandemic, which could disrupt their well-being fulfillment. The data were collected through an online survey of Jakarta citizens aged 46 years and older from the end of June to September 2021, and a total of 337 responses were accumulated. This study applied partial least square structural equation modeling to test the moderating effect of intrapersonal constraints toward …

Zoom Fatigue During The Covid-19 Pandemic: Is It Real?, Putri Winda Lestari, Adhila Fayasari

Kesmas

The coronavirus disease 2019 (COVID-19) pandemic has caused drastic changes to social lives moreover the activities done outside, such as work and school. The policy of large-scale social restrictions (LSRR)/Pembatasan Sosial Berskala Besar (PSBB), which makes people stay at home, also plays an important role in changing the face-to-face activity online. As a solution to the major change, people use video conferencing to keep in touch and still feel like doing "offline" activities. The increasing use of video conferencing has raised concerns about the resulting fatigue, termed "Zoom fatigue." This study aimed to describe Zoom fatigue during the COVID-19 pandemic …

Diabetes Mellitus And Mortality Among Covid-19 Patients In Jakarta, March-August 2020, Endang Widuri Wulandari, Sudarto Rotnoatmodjo, Ngabila Salama

Kesmas

Diabetes mellitus (DM) comorbidity is one of the risk factors for coronavirus disease 2019 (COVID-19) mortality. This study aimed to determine the association of comorbid DM and mortality among COVID-19 confirmed cases in DKI Jakarta Province, controlled with confounding variables from March to August 2020. The study design was a retrospective cohort using cox proportional hazard regression, with a total sample of 1,480. The data consisted of 740 COVID-19 cases with and 740 without comorbid DM. The inclusion criteria were COVID-19 confirmed cases with polymerase chain reaction (PCR) laboratory testing reported to the DKI Jakarta Provincial Department of Health, and …

Food Insecurity And Suicidal Behaviors Among Us High School Students*, Andrea D. Brown, Hilary Seligman, Sarah Silwa, Ellen Barnidge, Kathryn L. Krupsky, Zewiditu Demissie, Angela D. Liese

Faculty Publications

BACKGROUND: Food insecurity (FI) rates in the United States are particularly high among households with children. This research set aims to analyze if high school students experiencing FI had higher risk for mental health and suicidal behaviors.

METHODS: Using combined data from 11 states that conducted the 2017 Youth Risk Behavior Survey, a total of 26,962 and24,051 high school students were used to estimate race/ethnicity and sex-stratified prevalence ratios (PRs) from Poissonregression models. A single-question was used to measure the exposure of FI and outcomes of mental health and suicidalbehaviors.

RESULTS: Overall, 10.8% of students reported FI. Students experiencing FI …

Transmission Dynamics Of Covid-19 In Ghana And The Impact Of Public Health Interventions, Sylvia Ofori, Jessica S. Schwind, Kelly L. Sullivan, Benjamin J. Cowling, Gerardo Chowell, Isaac Fung

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

This study characterized COVID-19 transmission in Ghana in 2020 and 2021 by estimating the time-varying reproduction number (Rt) and exploring its association with various public health interventions at the national and regional levels. Ghana experienced four pandemic waves, with epidemic peaks in July 2020 and January, August, and December 2021. The epidemic peak was the highest nationwide in December 2021 with Rt ≥ 2. Throughout 2020 and 2021, per-capita cumulative case count by region increased with population size. Mobility data suggested a negative correlation between Rt and staying home during the first 90 days of the pandemic. The …

Needs Assessment Of Southeastern United States Vector Control Agencies: Capacity Improvement Is Greatly Needed To Prevent The Next Vector-Borne Disease Outbreak, Kyndall C. Dye-Braumuller, Jennifer R. Gordon, Danielle John, Josie Morrissey, Kaci Mccoy, Rhoel R. Dinglasan, Melissa Nolan Ph.D., Mph

Faculty Publications

A national 2017 vector control capacity survey was conducted to assess the United States’ (U.S.’s) ability to prevent emerging vector-borne disease. Since that survey, the southeastern U.S. has experienced continued autochthonous exotic vector-borne disease transmission and establishment of invasive vector species. To understand the current gaps in control programs and establish a baseline to evaluate future vector control efforts for this vulnerable region, a focused needs assessment survey was conducted in early 2020. The southeastern U.S. region was targeted, as this region has a high probability of novel vector-borne disease introduction. Paper copies delivered in handwritten envelopes and electronic copies …

Shining A Light On Marginal Food Insecurity In An Understudied Population Comment, Angela D. Liese

Faculty Publications

No abstract provided.

The Critical Value Of Maternal And Child Health (Mch) To Graduate Training In Public Health: A Framework To Guide Education, Research And Practice Comment, Julianna Deardorff, Michelle Menser Tissue, Patricia Elliott, Arden Handler, Cheryl Vamos, Zobeida Bonilla, Renee Turchi, Cecilia Sem Obeng, Jihong Liu, Holly Grason

Faculty Publications

Introduction

In light of persistent health inequities, this commentary describes the critical role of maternal and child health (MCH) graduate training in schools and programs of public health (SPPH) and illustrates linkages between key components of MCH pedagogy and practice to 2021 CEPH competencies.

Methods

In 2018, a small working group of faculty from the HRSA/MCHB-funded Centers of Excellence (COEs) was convened to define the unique contributions of MCH to SPPH and to develop a framework using an iterative and consensus-driven process. The working group met 5 times and feedback was integrated from the broader faculty across the 13 COEs. …

Dietary Score Associations With Markers Of Chronic Low-Grade Inflammation: A Cross-Sectional Comparative Analysis Of A Middle- To Older-Aged Population, Seán R. Miller, Pilar Navarro, Janas M. Harrington, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Ivan J. Perry, Catherine M. Phillips

Faculty Publications

Purpose

To assess relationships between the Dietary Approaches to Stop Hypertension (DASH), Mediterranean Diet (MD), Dietary Inflammatory Index (DII^®) and Energy-adjusted DII (E-DII™) scores and pro-inflammatory cytokines, adipocytokines, acute-phase response proteins, coagulation factors and white blood cells.

Methods

This was a cross-sectional study of 1862 men and women aged 46–73 years, randomly selected from a large primary care centre in Ireland. DASH, MD, DII and E-DII scores were derived from validated food frequency questionnaires. Correlation and multivariate-adjusted linear regression analyses with correction for multiple testing were performed to examine dietary score relationships with biomarker concentrations.

Results

In fully …

Molecular Characterization Of Rickettsial Agents In Ticks (Acari: Ixodidae) From Sri Lanka, Gregory A. Dasch, Marina Eremeeva, Maria L. Zambrano, Ranjan Premaratna, S. A. M. Kularatne

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Because the majority of spotted fever group rickettsiae are transmitted to humans by tick bites, it is important to understand which ticks might play a role in transmission of rickettsial pathogens in Sri Lanka. The purpose of our study was to conduct molecular surveillance of 847 ticks collected in different locations in central Sri Lanka to determine which were infected with Rickettsia and Anaplasmataceae. Molecular methods were used to identify the ticks and the agents detected. Most ticks (Amblyomma, Haemaphysalis, and Rhipicephalus) were collected by flagging, and lower number was collected from dogs, cattle, pigs, a …

Pro-Inflammatory Diet Pictured In Children With Atopic Dermatitis Or Food Allergy: Nutritional Data Of The Lina Cohort, Olivia Schütte, Larissa Bachmann, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Janine F. Felix, Stefan Röder, Ulrich Sack, Michaek Borte, Wieland Kiess, Ana C. Zenclussen, Gabriele I. Stangl

Faculty Publications

Background: Lifestyle and environmental factors are known to contribute to allergic disease development, especially very early in life. However, the link between diet composition and allergic outcomes remains unclear. Methods: In the present population-based cohort study we evaluated the dietary intake of 10-year-old children and analyses were performed with particular focus on atopic dermatitis or food allergy, allergic diseases known to be affected by dietary allergens. Dietary intake was assessed via semi-quantitative food frequency questionnaires. Based on these data, individual nutrient intake as well as children’s Dietary Inflammatory Index (C-DII™) scores were calculated. Information about atopic manifestations during the first …

Dietetic Intervention In Psoriatic Arthritis: The Dieta Trial, Beatriz F. Leite, Melissa A. Morimoto, Carina M. F. Gomes, Barbara N.C. Klemz, Patrícia S. Genaro, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Nágila R.T. Damasceno, Marcelo M. Pinheiro

Faculty Publications

Aim To evaluate whether dietary pattern changes, antioxidant supplementation or 5-10% weight loss could improve disease activity (skin and joint) in patients with psoriatic arthritis (PsA). Methods A total of 97 PsA patients were enrolled in this 12-week randomized, double-blinded, placebo-controlled trial. Patients were randomized into three groups: Diet-placebo (hypocaloric diet + placebo supplementation); Diet-fish (hypocaloric diet + 3 g/day of omega-3 supplementation; and Placebo. Food intake (3-day registry, Healthy Eating Index (HEI), and the Dietary Inflammatory Index (DII)), body composition (whole-body dual-energy X-ray absorptiometry (DXA), weight and waist circumference) and disease activity (PASI, BSA, BASDAI, DAS28-ESR, DAS28-CRP and MDA) …

Associations Among Plant-Based Dietary Indexes, The Dietary Inflammatory Index, And Inflammatory Potential In Female College Students In Saudi Arabia: A Cross-Sectional Study, Ghadeer S. Aljuraiban, Rachel Gibson, Leenah Al-Freeh, Sara Al-Musharaf, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert, Linda M. Oude, Queenie Chan

Faculty Publications

Background Saudi Arabian diets are transitioning to more Western dietary patterns that have been associated with higher levels of inflammation. Emerging evidence suggests plant-based diets are related to lower levels of inflammation; however, the definition of plant-based diets varies. Objective The purpose of this study was to identify the extent to which an overall Plant-Based Diet Index (PDI), Healthy-PDI (hPDI), and Unhealthy-PDI (uPDI) vs Energy-Adjusted Dietary Inflammatory Index correlate with high-sensitivity C-reactive protein (hs-CRP) level. Design This was a cross-sectional study carried out at King Saud University. Data on dietary intake, anthropometrics, and hs-CRP were collected. Participants/setting Female students aged …

Bright Light Treatment Of Combat-Related Ptsd: A Randomized Controlled Trial, Shawn D. Youngstedt, Christopher E. Kline, Alexandria Reynolds, Shannon K. Crowley, James B. Burch Ph.D., Nidha Khan, Seungyong Han

Faculty Publications

Introduction

Post-traumatic stress disorder (PTSD) is a prevalent consequence of combat with significant associated morbidity. Available treatments for PTSD have had limitations, suggesting a need to explore alternative or adjuvant treatments. Numerous rationales for bright light treatment of PTSD include its benefits for common PTSD comorbidities of depression, anxiety, and circadian misalignment and its relative ease of use with few side effects. The primary aims of this research were to examine the effects of bright light treatment for combat-related PTSD and associated morbidity. Materials and Methods

A randomized controlled trial was performed in N = 69 veterans with PTSD attributable …

Assessing The Effectiveness Of An Egg Intervention In The Nutritional And Food Security Status Of Infants And Toddlers From Rural Honduras, Aishat Adewoye, Mario Keko, Luke Roberson, Dziyana Nazaruk, Gisela Ramos, Laura Manship, Haresh Rochani, Asli Aslan, Ana M. Palacios

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

No abstract provided.

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 …

Depression And Factors Impacting Quality Of Life Among Adults With Asthma Presence In Nevada, Elizabeth D. Kahane, Lung-Chang Chien, Brian Labus, Dharini M. Bhammar, Jocy-Anna Chevalier, Sheniz Moonie

Epidemiology & Biostatistics Faculty Research

Background: Asthma, a chronic, non-communicable disease has been shown to negatively affect mental health and quality of life among adults. Annually approximately 8% of adult Nevadans report current asthma symptoms and 12.6% report having a lifetime diagnosis. The purpose of this study was to evaluate the association between asthma and depression and explore quality of life factors affecting adult Nevadans with asthma. Methods: Using behavioral risk factor surveillance system (BRFSS) data, this study evaluated the association between self-reported asthma and depression in Nevada using weighted multiple logistic regression. BRFSS asthma call-back survey (ACBS) data were used to determine the frequency …

Television Viewing Time And All-Cause Mortality: Interactions With Bmi, Physical Activity, Smoking, And Dietary Factors, Christopher T. Swain, Julie K. Bassett, Allison M. Hodge, David W. Dunstan, Neville Owen, Yi Yang, Harindra Jayasekara, James R. Hébert Scd, Nitin Shivappa Mbbs, Mph, Ph.D., Robert J. Macinnis, Roger L. Milne, Dallas R. English, Brigid M. Lynch

Faculty Publications

Background Higher levels of time spent sitting (sedentary behavior) contribute to adverse health outcomes, including earlier death. This effect may be modified by other lifestyle factors. We examined the association of television viewing (TV), a common leisure-time sedentary behavior, with all-cause mortality, and whether this is modified by body mass index (BMI), physical activity, smoking, alcohol intake, soft drink consumption, or diet-associated inflammation. Methods Using data from participants in the Melbourne Collaborative Cohort Study, flexible parametric survival models assessed the time-dependent association of self-reported TV time (three categories: < 2 h/day, 2-3 h/day, > 3 h/day) with all-cause mortality. Interaction terms were fitted to test whether …

Determinants Of Covid-19 Vaccinations Among A State-Wide Year-Long Surveillance Initiative In A Conservative Southern State, Lídia Gual-Gonzalez, Maggie S.J. Mccarter, Kyndall Dye-Braumuller, Stella Self, Connor H. Ross, Chloe Rodriguez-Ramos, Virginie G. Daguise, Melissa Nolan Ph.D., Mph

Faculty Publications

By the end of 2021, the COVID-19 pandemic resulted in over 54 million cases and more than 800,000 deaths in the United States, and over 350 million cases and more than 5 million deaths worldwide. The uniqueness and gravity of this pandemic have been reflected in the public health guidelines poorly received by a growing subset of the United States population. These poorly received guidelines, including vaccine receipt, are a highly complex psychosocial issue, and have impacted the successful prevention of disease spread. Given the intricate nature of this important barrier, any single statistical analysis methodologically fails to address all …

Cellular Dna Effects Of Radiation And Cancer Risk Assessment In Cells With Mitochondrial Defects, J. Chen, D. M. Sridharan, C. L. Cross, J. M. Pluth

Epidemiology & Biostatistics Faculty Research

Mitochondria play a key role in mediating non-targeted effects (NTE) post-radiation exposure. Mitochondrial DNA (mtDNA), due to its less efficient repair as compared to nuclear DNA, is more severely affected by radiation exposure and mutations in essential mtDNA genes can further exacerbate oxidative stress. Our objective was to evaluate the impact of mitochondrial defects on radiation-induced DDR and genomic instability, biomarkers that can foreshadow cancer development. To better understand this relationship, we used commercially available lymphoblastoid cell lines containing characterized mitochondrial mutations and studied the kinetics of DNA damage and relative telomere length (RTL) changes over time post 0.5 Gy …

Riding The Wave: Reactive Vector-Borne Disease Policy Renders The United States Vulnerable To Outbreaks And Insecticide Resistance, Kyndall C. Dye-Braumuller, Jennifer R. Gordon, Kaci Mccoy, Danielle Johnson, Rhoel Dinglasan, Melissa Nolan Ph.D., Mph

Faculty Publications

Funding for vector-borne disease surveillance, management, and research is cyclical and reactive in the United States. The subsequent effects have yielded gross inequities nationally that unintentionally support recurrent outbreaks. This policy forum is comprised of four primary subsections that collectively identify specific areas for improvement and offer innovative solutions to address national inadequacies in vector borne disease policy and infrastructure.

The Determinants Of Covid-19 Vaccine Acceptance In Sumatra, Cindy Sidarta, Andree Kurniawan, Nata P H Lugito, Jeremia Imanuel Siregar, Veli Sungono, Rivaldo Steven Heriyanto, Novia Lauren Sieto, Devina Adella Halim, Claudia Jodhinata, Saraswati Anindita Rizki, Terry Devita Sinaga, Chintya Marcella, Felix Wijovi, Billy Susanto, Elizabeth Marcella, Johan Wibowo, Jonathan Juniard Anurantha, Michelle Imanuelly, Michele Indrawan, Nadia Khoirunnisa Heryadi

Kesmas

In light of the current coronavirus disease 2019 (COVID-19) vaccination programs being implemented worldwide, this study aimed to evaluate the COVID-19 vaccine acceptance survey in Indonesia conducted by the World Health Organization (WHO), the Ministry of Health of the Republic of Indonesia, the National Immunization Technical Advisory Group (NITAG), and the United Nations Children's Fund (UNICEF), published in November 2020. It was found that Sumatra Island having lower COVID-19 vaccine acceptance rates, with Aceh Province displaying the lowest level of vaccine acceptance. Thus, a cross-sectional study was conducted, and a logistic regression analysis was used to identify the factors affecting …

Consumption Of Sugar-Sweetened Beverages And Its Potential Health Implications In Indonesia, Ratu Ayu D. Sartika, Atmarita Atmarita, M. I Zulkarnain Duki, Saptawati Bardosono, Lindawati Wibowo, Widjaja Lukito

Kesmas

The broad availability of sugar-sweetened beverages (SSBs) in the Indonesian market is increasing consumption. It, combined with escalating incidence and prevalence of diabetes and related non-communicable diseases (NCDs), and the ongoing debate on policies, has called for a comprehensive review as described in this study. Data was compiled from various sources but mainly gathered from the reported or published documents because of no direct access to the necessary data set. The lack of studies that assessed the direct relationship between SSB consumption and health outcomes in the Indonesian context also became a strong reason for the preparation of this review …

Body Image, Quality Of Life, And Their Predicting Factors In Pregnant Women: A Cross-Sectional Study, Zeynab Rezaei Fard, Arman Azadi, Yousef Veisani

Kesmas

Pregnancy can influence women’s psychological health, including body image and quality of life. This study aimed to examine the relationship between body image and quality of life and their predicting factors in pregnant women. This cross-sectional study was conducted on 250 pregnant women referred to health centers in Ilam City, Iran. Participants were selected using a random sampling method. Data collection tools comprised a sociodemographic questionnaire, Body Image Concern Inventory (BICI), and quality of life questionnaire (Short Form-12). Data were analyzed using statistical software. The mean ± SD of body image concern and quality of life was estimated at 31.77 …

The Estimation Of Excess Mortality During The Covid-19 Pandemic In Jakarta, Indonesia, Madona Yunita Wijaya

Kesmas

Indonesia is among the countries affected by the coronavirus disease 2019 (COVID-19) pandemic, and DKI Jakarta Province recorded the highest number of deaths. This study aimed to analyze the excess mortality across five administrative cities in Jakarta stratified by gender to assess the pandemic impact on mortality. The monthly mortality data from January 2018 to December 2020 was obtained through government sources. This data helped to measure excess mortality by estimating the baseline mortality had the COVID-19 pandemic not occurred. The analysis used a linear mixed model because of its ease and flexibility in forecasting subject-specific mortality. The results showed …