Factors associated with having uncontrolled asthma in rural Appalachia.

Background: Chronic respiratory disease disproportionately affects residents of Appalachia, particularly those residing in Central Appalachia. Asthma is particularly burdensome to Central Appalachian residents regarding cost and disability. Improving our understanding of how to mitigate these burdens requires understanding the factors influencing asthma control among individuals with asthma living in Central Appalachia, specifically rural Kentucky.

Environmental exposures and pulmonary function among adult residents of rural Appalachian Kentucky.

Background: Estimated residential exposures of adults to roadway density and several metrics of resource extraction, including coal mining and oil and gas drilling, were hypothesized to contribute to the prevalence of respiratory disease in rural Appalachia.

Objective: Determine how small-area geographic variation in residential environmental exposures impacts measures of pulmonary function among adults in a community-based study.

Methods: We examined associations between residential environmental respiratory exposures and pulmonary function among 827 adult participants of the "The Mountain Air Project", a community-based, cross-sectional study in Southeastern Kentucky during 2016-2018.

County incidence and geospatial trends of early-onset hypertensive disorders of pregnancy in Kentucky, 2008-2017.

Background: Early-onset hypertensive disorders of pregnancy (eHDP) are associated with more severe maternal and infant outcomes than later-onset disease. However, little has been done to evaluate population-level trends. Therefore, in this paper, we seek to address this understudied area by describing the geospatial and temporal patterns of county-level incidence of eHDP and assessing county-level demographics that may be associated with an increased incidence of eHDP.

Adult asthma associated with roadway density and housing in rural Appalachia: the Mountain Air Project (MAP).

Background: Appalachian Kentucky is a rural area with a high prevalence of asthma among adults. The relative contribution of environmental exposures in the etiology of adult asthma in these populations has been understudied.

Objective: This manuscript describes the aims, study design, methods, and characteristics of participants for the Mountain Air Project (MAP), and focuses on associations between small area environmental exposures, including roadways and mining operations, and lifetime and current asthma in adults.

A cross-sectional examination of the early-onset hypertensive disorders of pregnancy and industrial emissions of toxic metals using Kentucky birth records, 2008-2017.

This cross-sectional study assessed geospatial patterns of early-onset hypertensive disorders of pregnancy (eHDP) in primiparous mothers and exposure to industrial emissions using geocoded residential information from Kentucky live (N = 210,804) and still (N = 1,247) birth records (2008-2017) and census block group estimates of aerosol concentrations of arsenic (As), cadmium (Cd), chromium (Cr), lead (Pb), mercury (Hg), selenium (Se), and zinc (Zi) from the Risk Screening Environmental Indicators (RSEI) model. A latent class analysis allowed for the identification of four district exposure classes-As, Cd, and Pb (12.6%); Se and Zi (21.

Geocoding precision of birth records from 2008 to 2017 in Kentucky, USA.

Maternal address information captured on birth records is increasingly used to estimate residential environmental exposures during pregnancy. However, there has been limited assessment of the geocoding precision of birth records, particularly since the adoption of the 2003 standard birth certificate in 2015. To address this gap, this study evaluated the geocoding precision of live and stillbirth records of Kentucky residents over ten years, from 2008 through 2017.

Workers' compensation reported injuries among distillery industry workers, 2010-2019.

Background: The objective of this study was to identify the most frequent type, nature, and cause of work-related injuries among distillery workers and the contributing factors for these events to target interventions to reduce injuries.

Methods: Workers' compensation first reports of injury (FROI) from the years 2010 through 2019 were obtained. Variables were created for "occupational category" and "cause of injury" for evaluation of the injurious events.

Cancer diagnosis is associated with a lower burden of dementia and less Alzheimer's-type neuropathology.

Cancer and Alzheimer's disease are common diseases in ageing populations. Previous research has reported a lower incidence of Alzheimer's disease-type (amnestic) dementia among individuals with a diagnosis of cancer. Both cancer and amnestic dementia are prevalent and potentially lethal clinical syndromes.

Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project.

Background: Adult smoking prevalence in Central Appalachia is the highest in the United States, yet few epidemiologic studies describe the smoking behaviors of this population. Using a community-based approach, the Mountain Air Project (MAP) recruited the largest adult cohort from Central Appalachia, allowing us to examine prevalence and patterns of smoking behavior.

Methods: A cross-sectional epidemiologic study of 972 participants aged 21 years and older was undertaken 2015-2017, with a response rate of 82%.

Hollows as Sampling Units for Community-Based Participatory Research in Appalachia: The Mountain Air Project.

Background: In rural Appalachia, numerous geographical, historical, and socioeconomic barriers undermine health. We describe a community/academic partnership that leveraged local assets to implement an on-the-ground enumeration approach to enrolling participants, ultimately achieving an 82.1% response rate in a cross-sectional study of adult respiratory disease.

"Youth Are More Aware and Intelligent than Imagined": The Mountain Air Youth Photovoice Project.

Appalachian Kentucky reports some of the highest rates of respiratory illness in the United States, including chronic obstructive pulmonary disease and asthma. While smoking rates are high in the region, unexplained variation remains, and community-engaged research approaches are warranted to identify contributing factors. The Mountain Air Project's community advisory board recommended that investigators invite youth to provide their perspectives on possible contributing factors to respiratory illness, and we undertook an exploratory study to determine the utility of photovoice to elicit such perspectives with this population.

Association between buprenorphine/naloxone and high-dose opioid analgesic prescribing in Kentucky, 2012-2017.

Introduction: Buprenorphine/naloxone treatment is a highly effective treatment for opioid use disorder decreasing illicit opioid use and both all-cause and opioid-involved overdose mortality. The purpose of this study was to investigate the relationships between buprenorphine/naloxone prescribing and high-dose opioid analgesic prescribing (HDOAP) over time.

Methods: This longitudinal study used 2012-2017 Kentucky All Schedule Prescription Electronic Reporting data and cross-lagged structural equation analysis.

Missed Work Due to Occupational Illness among Hispanic Horse Workers.

Occupational illnesses are inadequately reported for agriculture, an industry dominated by a vulnerable Hispanic population and high fatal and nonfatal injury rates. Work-related illnesses can contribute to missed work, caused by a combination of personal and work factors, with costs to the individual, employer, and society. To better understand agricultural occupational illnesses, 225 Hispanic horse workers were interviewed via community-based convenience sampling.

Trends and Patterns of Opioid Analgesic Prescribing: Regional and Rural-Urban Variations in Kentucky From 2012 to 2015.

Purpose: Increased opioid analgesic prescribing (OAP) has been associated with increased risk of prescription opioid diversion, misuse, and abuse. We studied regional and rural-urban variations in OAP trends in Kentucky, from 2012 to 2015, and examined potential county-level risk and protective factors.

Methods: This study used prescription drug monitoring data.

Different types of housing and respiratory health outcomes.

Evidence has shown that housing conditions may substantially influence the health of residents. Different types of housing have different structures and construction materials, which may affect indoor environment and housing conditions. This study aimed to investigate whether people living in different types of housing have different respiratory health outcomes.

Geographical Clusters and Predictors of Rabies in Three Southeastern States.

The rabies virus causes progressive encephalomyelitis that is fatal in nearly 100% of untreated cases. In the United States, wildlife act as the primary reservoir for rabies; prevention, surveillance, and control costs remain high. The purpose of this study is to understand the current distribution of wildlife rabies in three southeastern states, with particular focus on raccoons as the primary eastern reservoir, as well as identify demographic and geographic factors which may affect the risk of human exposure.

Farm work injuries among a cohort of children in Kentucky, USA.

Children residing on farms with livestock may be at an increased risk for work-related injuries, compared to children who work on other commodity farms. This study characterizes children's work tasks on Kentucky farms and assesses whether children who work on beef cattle farms are at an increased risk for farm work injuries. The results of a cohort study of children aged 5-18 years (N=999 at baseline) working on family farms in Kentucky, followed for two consecutive years after an initial enumeration five years previously, found that 70% of the children were involved in animal-related chores.

Poor safety climate, long work hours, and musculoskeletal discomfort among Latino horse farm workers.

This study investigated the prevalence of self-reported musculoskeletal discomfort (MSD) and work-related factors associated with elevated MSD among Latino thoroughbred farm workers. Participants (N = 225) were recruited using a community-based purposive sampling approach to participate in in-person interviews. Of these workers, 85% experienced MSD.

Self-reported head injury and risk of late-life impairment and AD pathology in an AD center cohort.

Aims: To evaluate the relationship between self-reported head injury and cognitive impairment, dementia, mortality, and Alzheimer's disease (AD)-type pathological changes.

Methods: Clinical and neuropathological data from participants enrolled in a longitudinal study of aging and cognition (n = 649) were analyzed to assess the chronic effects of self-reported head injury.

Results: The effect of self-reported head injury on the clinical state depended on the age at assessment: for a 1-year increase in age, the OR for the transition to clinical mild cognitive impairment (MCI) at the next visit for participants with a history of head injury was 1.

Occupational health among Latino horse and crop workers in Kentucky: the role of work organization factors.

Agriculture is a dangerous industry often reliant on Latino workers, a vulnerable population. Using a work organization framework, this cross-sectional study analyzes the relationship between work organization variables and the occupational health of Latino crop (n = 49) and horse breeding (n = 54) workers in Kentucky. Increased levels of abusive supervision were associated with occupational injury (odds ratio [OR] = 2.

Limited association between perceived control and health-related quality of life in patients with heart failure.

Background: Perceived control has been suggested as a modifiable factor associated with health-related quality of life (HRQOL). However, the relationship between perceived control and HRQOL has not been evaluated in patients with heart failure (HF). The purpose of this study was to determine whether perceived control independently predicts HRQOL in HF patients.

Determinants of work hours among a cohort of male and female farmers 50 years and older in Kentucky and South Carolina (2002-2005).

The average age of United States farmers has been increasing for 20 years. The objective is to examine the factors associated with hours worked among farmers age 50 and older. A cohort of Kentucky and South Carolina farmers (n = 1394) over age 50 were surveyed annually during 2002-2005.

Comparison of 3-drug versus 4-drug and PI versus non-PI combinations as initial HAART: experience from 1998 to 2007.

Although established in controlled studies that there is no advantage to 4-drug highly active antiretroviral therapy (HAART) or regimens with or without protease inhibitors (PIs), we questioned this finding in a clinical setting (ie, no inclusion criteria). Ours is a single clinic retrospective study including all participants >18 years of age during their first year of HAART. A total of 190 participants were reviewed, with 168 (88%) attaining a viral load <400 copies/mL at the end of a year of HAART; 144 of 164 (88%) succeeded with 3 drugs and 24 of 26 (92%) with 4 drugs (P = .

Respiratory symptom reporting error in occupational surveillance of older farmers.

Objective: Agricultural health studies often use respiratory symptom report as a surrogate measure of disease and exposure; little data exists on the accuracy of symptom report in a work-motivated population.

Methods: Screening spirometry and telephone survey data for Kentucky male farmers >55 year (n = 134) in the NIOSH Farm Family Health and Hazard Surveillance Project were compared to investigate the accuracy of symptom report as a measure of respiratory disease risk in older farmers.

Results: The prevalence of reported obstructive respiratory symptoms was 0.

Identifying variables that predict falling asleep at the wheel among long-haul truck drivers.

Analysis of data from 843 long-haul truck drivers was conducted to determine the variables that predicted falling asleep at the wheel. Demographics, sleep-specific questions, and the Epworth Sleepiness Scale were used for analysis. More than 25% of the participants (n = 247) scored 10 or higher on the Epworth Sleepiness Scale, indicating chronic sleepiness.