Epidemiology Commons^™

The Epidemiology Of Sports And Recreation Related Toe Fractures In The United States, Dogerno Norceide, Gabriel I. Onor, Oluwatomi Akingbola, William Justice, Nana F. Amponsah, Abimbola Okulaja, Ifeanyichukwu Onor, Michael Okoronkwo, Chibuikem Nwizu, David Pedowitz, Md

Rothman Institute Papers

BACKGROUND: Fractures of the toes are among the most frequently diagnosed lower extremity fractures. In sports, toe fractures may present after diverse mechanisms of injury, varying severity, and varying implications for management. This study aimed to discern trends in toe fractures presenting to US emergency departments (EDs) particularly in association with sports and recreational activities. An additional aim of the study was to identify if rates of toe fracture presentation significantly decreased during the year 2020 at the height of the COVID-19 pandemic.

METHODS: We queried the National Electronic Injury Surveillance System (NEISS) database to identify toe fractures presented to …

Trends In The Incidence Of Ovarian Cancer Among Premenopausal And Postmenopausal Women In The United States, 2001 To 2021, Victor Adekanmbi, Abbey B Berenson, Batul Shakir, Christine D Hsu, Thao N Hoang, Itunu O Sokale, Tolulope T Sajobi, Fangjian Guo

Faculty, Staff and Students Publications

Background: Ovarian cancer remains the deadliest and leading cause of gynecological cancer-associated mortality in the US. The aim of this study was to characterize the trends in the incidence of ovarian cancer between premenopausal and postmenopausal women to inform future targeted interventions.

Methods: This population-based cross-sectional study analyzed data from the US Cancer Statistics (USCS) database, which covered the whole of the US population between 2001 and 2021. Joinpoint regression was used to compute the average annual percentage change (APC) with 95% confidence interval (CI) and age-standardized incidence rates per 1,000,000 population.

Results: The results showed that the IR of …

Hypertensive Disorders Of Pregnancy And Perinatal Outcomes: Two Prospective Cohort Studies Of Nulliparous Women In India And Tanzania, Andrea B. Pembe, Pratibha Dwarkanath, Amani Kikula, John Michael Raj, Nandita Perumal Phd, Heavenlight A. Paulo, Rajalakshmi M, Christopher P. Duggan, Honorati M. Masanja, Nandini Chopra, Mary M. Sando, Tinku Thomas, Cara A. Yelverton, Alfa Muhihi, Anura V. Kurpad, Wafaie E. Fawzi, Blair J. Wylie, Christopher R. Sudfeld

Faculty Publications

Introduction Hypertensive disorders of pregnancy (HDP) have been linked with increased risk for maternal and offspring complications in high-income settings. However, in resource-limited settings, studies with robust measurement of HDP, including severity and timing, and perinatal outcomes are limited.

Methods We analysed data from two prospective cohorts of nulliparous women in India (n=10 570 pregnancies) and Tanzania (n=10 299 pregnancies) who were enrolled in calcium supplementation trials and had blood pressure and proteinuria assessments throughout pregnancy and at the time of labour and delivery. Generalised estimating equations were used to assess the relationship between HDP severity categories (gestational hypertension, preeclampsia …

Epidemiological Trends Of Facial Fractures In The United States, Gabriel I. Onor, Ugochi T. Aguwa, Nicholas Barksdale, Isaiah X. Hughes, Molly Milano, Camila Cordero, Uche Nwagu, Oluwatomi Akingbola, Chibuzo J. Aguwa, Michael C. Okoronkwo

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Sustaining facial fractures may pose significant challenges to patients' health and quality of life. In the United States (U.S.), facial fractures account for 20 % of all sports-related injuries in pediatrics and many of these injuries are associated with traumatic brain injury. The objective of this study was to identify overall and sports-related incidence rates of facial fractures presenting to U.S. hospital emergency departments from 2014 to 2023 and define demographic risk factors for these injuries.

METHODS: The National Electronic Injury Surveillance System was queried to identify facial fractures from 2014 to 2023 as well as associated demographic data. …

Prevalence, Antimicrobial Resistance Characteristics And Virulence Genes Of Streptococcus Suis In Pigs In Upper Northern Thailand, Wanida Mala, Rangsiya Prathan, Si Thu Hein, Sunpetch Angkittitrakul, Asinamai Athliamai Bitrus, Rungtip Chuanchuen

The Thai Journal of Veterinary Medicine

This study aimed to investigate the prevalence, virulence genes and antimicrobial resistance of Streptococcus suis from pigs in Upper-Northern Thailand. A total of 768 nasal swabs were obtained from pigs at the municipal slaughterhouses in five provinces including Phayao (n=202), Nan (n=190), Chiang Rai (180), Chiang Mai (n=130), and Mae Hong Son (n=66) in 2018-2019. The prevalence of S. suis varied from 3.0%-9.4%, of which the highest prevalence was in Chiang Rai (9.4%) and Mae Hong Son (9.1%). Of all 59 isolates confirmed to be S. suis, serotype 8 (50.8%) was most commonly identified, followed by serotype 10 (3.4%), …

Topical Lifitegrast Therapy For Dry Eye Disease, Lama Assi, Salim C. Lutfallah, Tsz Wing Yim, Su Hsun Liu, Sharon J. Duffy, Jayne Weiss

School of Medicine Faculty Publications

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effectiveness and safety of topical lifitegrast therapy alone or in combination with artificial tears, compared with a placebo, artificial tears alone, or no treatment for dry eye disease.

Association Between Dietary Inflammatory And Antioxidant Potential And Systemic Inflammatory And Oxidative Status With The Risk And Severity Of Coronary Artery Disease, Zahara Namkhah, Elham Alipoor, Manhnaz Salmani, Negar Ebrahimi, Monireh Ahmadpanahi, Ali Vasheghani-Farahani, Mehdi Yaseri, Michael David Wirth, Longgang Zhao, James Hébert Scd, Javad Hosseinzadeh-Attar

Faculty Publications

Background and aims

Unhealthy diets have pro-inflammatory properties that have been shown to contribute to coronary artery disease (CAD). The dietary inflammatory index (DII®) and the dietary antioxidant quality score (DAQS) quantify the anti-/pro-inflammatory and antioxidant potential of a diet. This study aims to investigate the association between the energy-adjusted DII (E-DIITM), DAQS, oxidant/anti-oxidant biomarkers, and CAD risk and severity.

Methods and results

This cross-sectional study investigated 158 participants for the presence and severity of CAD based on coronary angiography. E-DII and DAQS scores, malondialdehyde (MDA), total oxidant status (TOS), glutathione peroxidase (GPX) activity, total antioxidant capacity (TAC) and conventional …

Identification Of Hypoxia-Inducible Factor Hif1a As A Therapeutic Target During Sars-Cov-2-Associated Lung Injury, Bentley Bobrow, Samuel D Luber, Paul Potnuru, Katherine Figarella, Jieun Kim, Yanyu Wang, In Hyuk Bang, David Robinson, Paulina B Sergot, Steven K Burke, Tingting Mills, Constanza De Dios, Robert Suchting, George W Williams, Adit A Ginde, Yafen Liang, Hongfang Liu, Charles Green, Marie-Francoise Doursout, Alparslan Turan, Daniel I Sessler, Xiaoyi Yuan, Holger K Eltzschig

Faculty, Staff and Student Publications

Hypoxia-inducible factors (HIFs) promote lung protection and pathogen eradication during acute lung injury. We therefore tested the theory that pharmacologic stabilization of HIFs dampens lung injury during SARS-CoV-2 pneumonia. Initial studies in murine SARS-CoV-2 models showed improved outcomes after treatment with the FDA-approved HIF-stabilizer vadadustat. Subsequent studies in genetic models implicated alveolar-expressed Hif1a in mediating lung protection. Therefore, we performed a randomized, double-blinded, multicenter phase 2 trial in patients admitted for SARS-CoV-2 infection and concomitant hypoxia (SpO2 ≤ 94%). Patients (n=448) were randomized to oral vadadustat (900 mg/day) or placebo for up to 14 days. Safety events were similar between …

Beyond The Genome: The Racialized Exposome, Flourishing, And Stress Biology In African Americans, A Non-Exhaustive Review, Enye Washington

University Honors Theses

Racial health disparities remain an enduring challenge in the United States, disproportionately impacting African American communities through higher rates of chronic disease and premature mortality. This non-exhaustive literature explores how the racialized exposome - a term denoting the totality of social, environmental, and structural stressors rooted in systemic racism - biologically embeds itself via stress-responsive pathways. Specifically, it examines the interaction between racial stress, flourishing, and key biological markers, including allostatic load and telomere length, considering the gut-brain axis. The review highlights robust evidence that chronic exposure to racial discrimination and structural adversity contributes to multisystem dysregulation and accelerated cellular …

Predictive Model For Hemoglobin Levels Using Multiple Linear Regression, Dien Gusta Anggraini Nursal, Muhammad Daffa Atthariq Winata, Nohan Arum Romadlona, Noura Rizki, Sabillah Nasitoh, Muhammad Sakhi Baretta

Journal of Health Research

Background: Anemia is a condition in which the number of red blood cells or hemoglobin (Hb) levels fall below normal, limiting the ability of blood to transport oxygen effectively. This study aimed to develop a predictive model for Hb levels by identifying significant risk factors.

Method: This observational analytic study was conducted among 103 randomly selected students of Bung Hatta University in Padang, Indonesia. Data were collected with a questionnaire and a hemoglobin test between April to May 2024. Pearson’s correlation analysis and multiple linear regression were performed in this study.

Results: Bivariate analysis showed significant correlations between Hb levels …

Nafld Surveillance In The Alaska Native/American Indian Population, Wileina Saumara Rhodes

Walden Dissertations and Doctoral Studies

In the United States, the prevalence of NAFLD is estimated at 24% of the population, and by 2030, the incidence of NAFLD will increase to 100.9 million cases. This study aimed to determine the prevalence and rate of non-alcoholic fatty liver disease (NAFLD) progression in the Alaska Native/ American Indian population (AN/AI) with and without elevated liver function tests. Two research questions guided the study: Do outcomes (abnormal/normal) of LFTs, A1C, lipids, BMI, and inflammatory markers predict or have a relationship with NAFLD progression? Does NAFLD surveillance have a relationship with the patient’s outcome as measured by the NAFLD Fibrosis …

Childhood Myopia Part Ii: Treatment Mechanisms, Emerging Options, And Considerations, Safal Khanal Dr, Erin S. Tomiyama Dr, Síofra Harrington Dr

Articles

Abstract

The rapidly increasing prevalence of myopia and its association with vision-threatening complications in later life has intensified efforts to identify treatments that can prevent the onset and slow the progression of myopia in children. These efforts have led to the development of several optical, environmental, and pharmacological myopia control treatments. Investigations of additional treatment options are ongoing and have shown great promise for clinical translation. Although significant progress has been made in identifying potential pathways and modes of action of these treatments, a complete mechanistic understanding is still lacking. This critical review article explores the potential mechanisms underlying the …

Prevalence And Associated Factors Of Mental And Substance Use Problems Among Adults In Kenya: A Community-Based Cross-Sectional Study, Patrick Nzivo Mwangala, Anita Kerubo, Millicent Makandi, Rachel Odhiambo, Amina Abubakar

Institute for Human Development, East Africa

Data on the burden and determinants of mental and substance use problems among women in urban and rural informal settlements in Kenya is sparse, thus limiting preventive and treatment efforts in these areas. To bridge the gap, we (a) determined the prevalence of depressive, anxiety and post-traumatic stress disorder (PTSD) symptoms and alcohol and drug use problems among women compared to their spouses and (b) examined the correlates of these outcomes. Data collection for this cross-sectional survey was conducted in 2022 in Mombasa, Kwale and Nairobi counties in Kenya. A total of 1528 adults (1048 women) took part. The 9-Item …

Mechanisms Of Interventions Targeting Modifiable Factors For Dementia Risk Reduction, Anna Matton, Ruth Stephen, Makrina Daniilidou, Mariagnese Barbera, Vilma Alanko, Marcel Ballin, Jamie Ford, Katri Hemiö, Jenni Lehtisalo, Chinedu Momoh

Brain and Mind Institute

The global prevalence of dementia is increasing. With no widely available and accessible treatments to halt or reverse the progression of dementia, exploring preventative strategies is critical. Lifestyle-based interventions show promise in preventing or delaying dementia onset. However, understanding the complex and multifactorial mechanisms underlying dementia, and how interventions target these pathways, is essential for developing personalized and effective strategies. In this review, we examined the current evidence of the mediating pathways in dementia risk reduction. We focused on mechanisms investigated in single-domain interventions on physical exercise, cognitive training, diet, metabolic/cardiovascular or psycho-social risk factors in line with those combined …

Small And Sick Newborn Care: Changes In Service Readiness Scoring Between Baseline And 2023 For 65 Neonatal Units Implementing With Nest360 In Kenya, Malawi, Nigeria, And Tanzania, Rebecca E. Penzias, Morris Ondieki Ogero, Robert Tillya, Irabi Kassim, Olabisi Dosunmu, Opeyemi Odedere, Hannah Mwaniki, Vincent Ochieng, Dolphine Mochache, William Macharia

Paediatrics and Child Health, East Africa

Health Facility Assessments (HFAs) are important for measuring and tracking service readiness for small and sick newborn care (SSNC). NEST360 Alliance aims to reduce neonatal mortality in four countries (Kenya, Malawi, Nigeria, Tanzania). NEST360 and UNICEF facilitated HFA tool design with ministries of health in four African countries and developed two complimentary approaches to summarize readiness. Using the NEST360/UNICEF HFA tool, we collected data, developed two service readiness scoring approaches for SSNC (standards-based scoring by adapted World Health Organization (WHO) health system building blocks (HSBBs) and assessing service readiness across the health system, and level-2+ scoring by WHO clinical interventions), …

Supplementation With Ready-To-Use Therapeutic Food Has No Effect On Adverse Outcomes Among Undernourished Children Aged 6–59 Months With Severe Pneumonia, Damalie Nalwanga, Elisa Giallongo, Victor Musiime, Sarah Kiguli, Peter Olupot-Olupot, Florence Alaroker, Robert Opoka, Abner Tagoola, Mainga Hamaluba, Christabel Mogaka

Paediatrics and Child Health, East Africa

Objectives: To investigate the effect of supplementation with ready-to-use therapeutic food (RUTF) on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia.

Methods: This secondary analysis of the COAST-Nutrition (ISRCTN10829073) included children hospitalized for severe pneumonia in Uganda and Kenya. Undernutrition was defined as having either a weight-for-age z score, height-for-age z score, or weight-for-height/length z score below the median of the WHO reference population (< 0) or mid-upper arm circumference (MUAC) below 13.5 cm. Participants were randomized to receive 1 sachet of RUTF daily for 8 weeks in addition to the usual diet (intervention) or usual diet alone (control). The primary composite outcome for adverse events was any one of mortality, re-admission, or deterioration of nutritional status by day 90 of follow-up.

Results: Of 846 main trial participants, 741 (88%) met the inclusion criteria (intervention: 374 versus control: 367). Of 687 (93%) participants in whom the primary outcome was assessed, 370 …

Sunlight Exposure And The Risk Of Mortality And Breast Cancer Incidence, Noor Nadhim

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Prolonged sun exposure increases the risk of skin cancer. However, multiple sunlight-related health benefits have been identified. The overall impact of sun exposure on mortality is not clear. Sunlight could be associated with breast cancer risk via stimulating vitamin D photosynthesis; however, evidence has been mixed. Objectives: To investigate the association of time spent outdoors in daylight (in warmer and cooler months, and the total [annual]) and UV irradiance using the residential locations of participants with the risks of mortality (all-cause and cause-specific: cancer, cardiovascular [CVD], and non-cancer non-CVD) and primary invasive breast cancer.

Methods: This research …

Tobacco, Alcohol, And Poverty In Lao Pdr Based On National Survey Analysis, Robert M. Semakula

Loma Linda University Electronic Theses, Dissertations & Projects

Tobacco and alcohol use are among the most prevalent and harmful addictive behaviors globally, including in the Lao People’s Democratic Republic (Lao PDR). In Southeast Asia and the Western Pacific, substance use patterns are shaped by cultural, social, economic, policyrelated, and environmental factors. This study aimed to: (1) explore associations between different patterns of alcohol and tobacco use among men and women in Lao PDR, and (2) investigate the effect of poverty on the relationship between alcohol and tobacco use. We conducted a secondary analysis of the 2013 Lao National Adult Tobacco Survey (N = 9,706), a nationally representative sample …

Geographic Inequalities, And Social-Demographic Determinants Of Reproductive, Maternal And Child Health At Sub-National Levels In Kenya, Janette Karimi, Anitah Cherono, Victor Alegana, Martin Mutua, Hellen Kiarie, Rose Muthee, Marleen Temmerman, Peter Gichangi

Centre of Excellence in Women and Child Health

Background; Global initiatives have emphasized tracking indicators to monitor progress, particularly in countries with the highest maternal and child mortality. Routine data can be used to monitor indicators for improved target setting at national and subnational levels. Our objective was to assess the geographic inequalities in estimates of reproductive, maternal and child health indicators from routine data at the subnational level in Kenya.

Methods; Monthly data from 47 counties clustered in 8 regions, from January 2018 to December 2021 were assembled from the District Health Information Software version 2 (DHIS2) in Kenya. This included women of reproductive age receiving family …

The Relationship Between Lifetime Trauma Exposure And Psychosis In A Multi-Country Case-Control Study In Africa, Anne Stevenson, Supriya Misra, Engida Girma, Dickens Akena, Melkam Alemayehu, Amantia Ametaj, Bizu Gelaye, Stella Gichuru, Symon Kariuki, Lukoye Atwoli

Internal Medicine, East Africa

Background: Exposure to traumatic events is a known risk factor for psychosis. Additionally, psychosis may be a risk factor for exposure to traumatic events. There are little data on the relationship between traumatic events and psychosis in sub-Saharan Africa, particularly in large, cross-country samples using the same instrument.

Methods: In a case-control study, 21,606 adults were recruited with psychosis (cases) and 21,329 adults without any history of psychosis (controls) in Ethiopia, Kenya, South Africa, and Uganda from 2018 to 2023 (n = 42,935). Lifetime trauma exposure was assessed using the Life Events Checklist-5. Regression models included the: i) prevalence of …

Europe–Africa Collaboration: Working Together To Strengthen Health Research, Implementation, And Equitable Systems, Lara Pandya, Irene Norstedt, Martin Seychell, Emer Cooke, Isabel De La Mata Barranco, Niklas Blomberg, Marleen Temmerman, Michael Makanga

Centre of Excellence in Women and Child Health

In September 2024, key representatives from European Union (EU) directorates and agencies convened to enhance collaboration with Africa in strengthening health research, innovation, and implementation. The meeting focused on bolstering joint efforts to improve health outcomes and support wellbeing across all ages in Africa. Despite progress in addressing infectious diseases, the continent faces a dual burden with the rise of non-communicable diseases and emerging threats such as antimicrobial resistance, climate change, falsified medicines, and pandemic risks. These challenges are exacerbated by fragile health systems, rapid population growth, urbanisation, and limited access to affordable medical interventions.

To address these issues, the …

Intersectoral Interventions: Integration For Impact On Preterm Birth, Etienne V. Langlois, Maria El Bizri, Kelly Thompson, Amy Reid, Merette Khalil, Giulia Gasparri, Joy E. Lawn, Teesta Dey, Judith Robb-Mccord, Marleen Temmerman

Centre of Excellence in Women and Child Health

Progress: The last two decades have seen a growing focus on intersectoral interventions to improve maternal and newborn health and well-being outcomes, as refected in eforts to achieve the Millennium Development Goals (MDGs) and advance the Sustainable Development Goals (SDGs). Preterm births are linked to cross-sectoral determi‑ nants that afect health outcomes and human capital across the life-course, necessitating an intersectoral approach that addresses these multifaceted challenges.

Programmatic priorities: Recognizing that social, biological and economic determinants signifcantly infuence health outcomes, it is critical that robust health systems are reinforced by a comprehensive intersectoral approach. Evidence suggests that the factors infuencing …

Fine-Scale Population Structure Of Japanese Helicobacter Pylori Provides New Anthropological And Epidemiological Insights, Kohei Tomonari, Batsaikhan Saruuljavkhlan, Ricky Indra Alfaray, Kartika Afrida Fauzia, Osamu Matsunari, Daisuke Chinda, Tadashi Shimoyama, Phawinee Subsomwong, Nagisa Kinjo, Tetsu Kinjo, Yasuo Hanamure, Masato Shinzato, Rumiko Suzuki, Fukunori Kinjo, Shigeru Takigami, Toshio Fujioka, Takeshi Matsuhisa, Junko Akada, Takashi Matsumoto, Yoshio Yamaoka

Faculty, Staff and Students Publications

Helicobacter pylori is considered to contribute to gastric cancer and is also used as a marker to trace human migration due to its co-evolution with humans. To understand the recently proposed tripartite model suggesting three ancestral origins for the Japanese population and address the enigma of the high incidence of gastric cancer in Northeast Hondo (Hondo is mainland Japan), we conducted a fine-scale population structure analysis using a large Japanese H. pylori dataset, including 438 strains from 9 regions based on whole-genome sequences. As a result of fineSTRUCTURE analysis, it was found that H. pylori in Northeast Hondo is genetically …

Investigating The Associations Of Cognitive Health, Health Behaviors, And Personality In Older Community-Dwelling Adults, Yan-Jhu Su

Graduate Doctoral Dissertations

Cognitive decline poses a significant public health challenge, with profound implications for aging populations. This dissertation investigates the associations between health behaviors, leisure activities, personality traits, and cognitive function in older U.S. adults, using data from the Health and Retirement Study (HRS) and the Consumption and Activities Mail Survey (CAMS). This work comprises three studies that explore both cross-sectional and longitudinal perspectives on cognitive aging.

Study 1 examines the complex interactions between personality traits, education, health behaviors, and cognitive function. The study is divided into two parts: Study 1a explores the role of health behaviors—smoking, alcohol use, and physical activity—as …

Risk Factors Associated With Long Covid Among Hospitalized Adults In Several Hospitals In Palembang City, Indonesia, Hotma Martogi Lorensi Hutapea, Mondastri Korib Sudaryo, Arli Aditya Parikesit, Tri Yunis Miko Wahyono, Nelda Aprilia Salim

Kesmas

Long COVID is characterized by one or more symptoms experienced by individuals prior to a COVID-19 infection that last for ≥2 months, and its risk factors remain unclear. This study aimed to identify risk factors associated with long COVID among patients admitted between June 1, 2020, and October 31, 2023, at three referral COVID-19 hospitals in Palembang City, Indonesia. This cohort study included adults who were admitted for ≥5 days. The participant’s medical records were reviewed for admission and discharge dates, sociodemographic and clinical characteristics, and vaccination and therapy status. A standardized and validated instrument was used to assess fatigue …

Machine Learning For Preeclampsia Prediction: Enhancing Screening In Primary Health Care, Dwirani Amelia, Asri Adisasmita, Kemal N. Siregar, Detty Siti Nurdiati

Kesmas

Preeclampsia is a leading cause of maternal morbidity and mortality worldwide, with early detection being critical for reducing adverse outcomes. This study aimed to develop a machine learning model for predicting the risk of preeclampsia using readily available maternal characteristics such as body mass index, mean arterial pressure, and clinical history of hypertension or diabetes mellitus. Secondary data from 2,250 pregnancies were analyzed, addressing challenges such as missing data and class imbalance through preprocessing. Various algorithms, including support vector machines, random forest, and logistic regression, were evaluated. Herein, a support vector machines model with threshold adjustment showed the best performance, …

Understanding Vaccine Hesitancy And Barriers To Access In Hispanic Individuals Of Metro Detroit​, Rafael Ramos, John Gallegher, Nevil Khurana, Ingrid Rocha, Rene Andino-Galva, Izabel Thomas, Deni Peterson, Alexander Eskandarian, Eliezer Arody Gomez, Md

Medical Student Research Symposium

Background:

Detroit’s Hispanic community is still disproportionally uninsured at about 2x the rate of non-Hispanic white and 3x the rate of non-Hispanic Black residents. In the post-COVID era, vaccine hesitancy and barriers to access have been well-documented. Studies suggest that minority populations, including the Hispanic population, may experience unique social determinants of health which affect their vaccination rates and outcomes. Additionally, research shows that knowledge of vaccines may correlate with levels of trust.

Methods:

We sought to describe the knowledge, barriers to access, and levels of trust regarding the influenza (flu) vaccine in Hispanic individuals of Metro Detroit. We used …

Socioeconomic Disparities In Breast Cancer Survival: Examining Potential Mediator Role Of Oncotype Dx(Odx) Test And Stage At Diagnosis Among Hr+/Her2- Breast Cancer Women, Pratibha Shrestha, Qingzhao Yu, Edward S. Peters, Edward Trapido, Mei Chin Hsieh, Tekeda Ferguson, Quyen D. Chu, Xiao Cheng Wu

School of Public Health Faculty Publications

Background: Women with a lower socioeconomic status (SES) have an increased risk of dying from breast cancer (BC) than those with a higher SES. The association of SES with BC survival may be partially mediated by factors such as Oncotype DX (ODX) testing and stage at diagnosis. This study aims to examine SES disparities in survival among HR+/HER2- BC women and to quantify the mediating effects of the ODX test and stage. Methods: We used data from the Louisiana Tumor Registry to identify women aged 20–90 years diagnosed with stage I–II in 2011–2014 and stage I–III in 2015–2017 HR+/HER2- BC …

Intersectional Analysis Of Vaccination Inequity Among Individuals With Disabilities In The United States During The Covid-19 Pandemic, Philip Ndoki, Heba M. Athar, David O. Anderson

Journal of Social, Behavioral, and Health Sciences

We investigated how disability status, types, sociodemographic indicators, and reasons for not receiving vaccinations influenced COVID-19 vaccination rates among individuals with disabilities in the United States. Despite efforts, vaccination disparities persisted, necessitating a nuanced understanding of the barriers to vaccination. Using intersectionality theory and the social determinants of health framework, we examined the impact of marginalized identities and structural inequalities. Key questions included the association between disability status and vaccination uptake, differences among disability types moderated by sociodemographic factors, and the interaction between disability status and reasons for not vaccinating. We used Household Pulse Survey data from the U.S. Census …

Exposure To Second-Hand Smoke In Homes And Respiratory Symptoms Among Non-Smoking Adults In Depok, Indonesia 2025, Faraz Ali, Budi Hartono

Journal of Indonesian Health Policy and Administration

Second-hand smoke (SHS) exposure in the home environment has become a public health emergency, especially in countries with very high smoking rates, such as Indonesia. SHS exposure has already presented evidence of symptoms of the respiratory category, like a cough and shortness of breath. This study aimed to assess the association between exposure to SHS at home and the presence of respiratory symptoms among non-smoking adults in Depok, Indonesia. Convenience sampling was adopted for enrolling 108 non-smoking adults aged 18-30 who were jointly exposed to SHS in their homes for a cross-sectional study. Data aggregations of gatherings were performed using …