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Concept: Kentucky


Ground-level ozone is adverse to human and vegetation health. High ground-level ozone concentrations usually occur over the United States in the summer, often referred to as the ozone season. However, observed monthly mean ozone concentrations in the southeastern United States were higher in October than July in 2010. The October ozone average in 2010 reached that of July in the past three decades (1980-2010). Our analysis shows that this extreme October ozone in 2010 over the Southeast is due in part to a dry and warm weather condition, which enhances photochemical production, air stagnation, and fire emissions. Observational evidence and modeling analysis also indicate that another significant contributor is enhanced emissions of biogenic isoprene, a major ozone precursor, from water-stressed plants under a dry and warm condition. The latter finding is corroborated by recent laboratory and field studies. This climate-induced biogenic control also explains the puzzling fact that the two extremes of high October ozone both occurred in the 2000s when anthropogenic emissions were lower than the 1980s and 1990s, in contrast to the observed decreasing trend of July ozone in the region. The occurrences of a drying and warming fall, projected by climate models, will likely lead to more active photochemistry, enhanced biogenic isoprene and fire emissions, an extension of the ozone season from summer to fall, and an increase of secondary organic aerosols in the Southeast, posing challenges to regional air quality management.

Concepts: Chemistry, Florida, North Carolina, Southern United States, Georgia, Kentucky, Tennessee, West Virginia


Coal workers' pneumoconiosis, also known as “black lung disease,” is an occupational lung disease caused by overexposure to respirable coal mine dust. Inhaled dust leads to inflammation and fibrosis in the lungs, and coal workers' pneumoconiosis can be a debilitating disease. The Federal Coal Mine Health and Safety Act of 1969 (Coal Act),* amended in 1977, established dust limits for U.S. coal mines and created the National Institute for Occupational Safety and Health (NIOSH)-administered Coal Workers' Health Surveillance Program with the goal of reducing the incidence of coal workers' pneumoconiosis and eliminating its most severe form, progressive massive fibrosis (PMF),(†) which can be lethal. The prevalence of PMF fell sharply after implementation of the Coal Act and reached historic lows in the 1990s, with 31 unique cases identified by the Coal Workers' Health Surveillance Program during 1990-1999. Since then, a resurgence of the disease has occurred, notably in central Appalachia (Figure 1) (1,2). This report describes a cluster of 60 cases of PMF identified in current and former coal miners at a single eastern Kentucky radiology practice during January 2015-August 2016. This cluster was not discovered through the national surveillance program. This ongoing outbreak highlights an urgent need for effective dust control in coal mines to prevent coal workers' pneumoconiosis, and for improved surveillance to promptly identify the early stages of the disease and stop its progression to PMF.

Concepts: Epidemiology, Pulmonology, Asthma, Coal, Occupational safety and health, Kentucky, Coal mining, Anthracite


We describe the thirteenth reported case of human infection with Gongylonema spp. in the United States and the first to be confirmed as Gongylonema pulchrum. The parasite described was isolated from the oral cavity of a resident of Williamsburg, Virginia. The identity of the parasite was verified through morphologic and genetic approaches, and provided the first genetic confirmation of a Gongylonema sp. in humans.

Concepts: United States, U.S. state, Race, Latin, Humid subtropical climate, Kentucky, Thomas Jefferson, Gongylonema pulchrum


On January 20, 2016, New Jersey Governor Chris Christie vetoed a bill passed with strong bipartisan support by his state legislature that would have raised New Jersey’s minimum age of sale for tobacco products to 21. The veto is a setback in an otherwise accelerating movement toward dissemination of “Tobacco 21” laws as a new tool for reducing young people’s access to cigarettes and e-cigarettes. In 2013, only 8 U.S. localities had adopted Tobacco 21 laws. By March 2016, at least 125 localities and the state of Hawaii had done so, and California was on the cusp of following suit. . . .

Concepts: United States, Tobacco, United States Congress, United States Constitution, New Jersey, Asian American, Kentucky, Filipino American


Nonmedical prescription opioid misuse remains a growing public problem in need of action and is concentrated in areas of US states with large rural populations such as Kentucky, West Virginia, Alaska, and Oklahoma. We developed hypotheses regarding the influence of 4 factors: (1) greater opioid prescription in rural areas, creating availability from which illegal markets can arise; (2) an out-migration of young adults; (3) greater rural social and kinship network connections, which may facilitate drug diversion and distribution; and (4) economic stressors that may create vulnerability to drug use more generally. A systematic consideration of the contexts that create differences in availability, access, and preferences is critical to understanding how drug use context varies across geography. (Am J Public Health. Published online ahead of print December 12, 2013: e1-e8. doi:10.2105/AJPH.2013.301709).

Concepts: Population, United States, U.S. state, Opioid, Rural, Illegal drug trade, Kentucky, West Virginia


Although Hispanic mothers in the United States have slightly higher rates of breastfeeding initiation than the national average, they are more likely to supplement with formula.

Concepts: United States, Poverty in the United States, U.S. state, California, Latin America, New Jersey, Humid subtropical climate, Kentucky


Describe tobacco companies' marketing strategies targeting low socioeconomic status (SES) females in the USA.

Concepts: United States, Socioeconomic status, Tobacco, Woman, Marketing, World Health Organization, Kentucky, Tobacco industry


State Medicaid programs can cover tobacco cessation therapies for millions of low-income smokers in the United States, but use of this benefit is low and varies widely by state. This article assesses the effects of changes in Medicaid benefit policies, general tobacco policies, smoking norms, and public health programs on the use of cessation therapy among Medicaid smokers.

Concepts: United States, Nicotine, Poverty in the United States, U.S. state, World Health Organization, Massachusetts, Kentucky, Articles of Confederation


We estimate the prevalence of malnutrition among older patients presenting to an emergency department (ED) in the southeastern United States and identify subgroups at increased risk.

Concepts: Hospital, United States, Illness, U.S. state, Dublin, Kentucky


Cross-sector partnerships benefit public health by leveraging ideas, resources, and expertise from a wide range of partners. In this study we documented the process and impact of AIR Louisville (a collaboration forged among the Louisville Metro Government, a nonprofit institute, and a technology company) in successfully tackling a complex public health challenge: asthma. We enrolled residents of Louisville, Kentucky, with asthma and used electronic inhaler sensors to monitor where and when they used medication. We found that the use of the digital health platform achieved positive clinical outcomes, including a 78 percent reduction in rescue inhaler use and a 48 percent improvement in symptom-free days. Moreover, the crowdsourced real-world data on inhaler use, combined with environmental data, led to policy recommendations including enhancing tree canopy, tree removal mitigation, zoning for air pollution emission buffers, recommended truck routes, and developing a community asthma notification system. AIR Louisville represents a model that can be replicated to address many public health challenges by simultaneously guiding individual, clinical, and policy decisions.

Concepts: Health care, Epidemiology, Air pollution, Ohio River, Kentucky, Inhaler, Address space, Louisville, Kentucky