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  1. Article ; Online: Revisiting transformative WASH: measuring impact.

    Stoler, Justin / Guzmán, Danice B / Adams, Ellis A

    The Lancet. Global health

    2023  Volume 11, Issue 4, Page(s) e493–e494

    MeSH term(s) Humans ; Hygiene ; Sanitation
    Language English
    Publishing date 2023-01-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2723488-5
    ISSN 2214-109X ; 2214-109X
    ISSN (online) 2214-109X
    ISSN 2214-109X
    DOI 10.1016/S2214-109X(23)00013-X
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  2. Article ; Online: The Impact of Rapid Handpump Repairs on Diarrhea Morbidity in Children: Cross-Sectional Study in Kwale County, Kenya.

    Thomson, Patrick / Stoler, Justin / Byford, Michelle / Bradley, David J

    JMIR public health and surveillance

    2024  Volume 10, Page(s) e42462

    Abstract: Background: Handpumps are used by millions of people as their main source of water. Although handpumps represent only a basic form of water provision, there have been continuous efforts to improve the performance of these systems as they are likely to ... ...

    Abstract Background: Handpumps are used by millions of people as their main source of water. Although handpumps represent only a basic form of water provision, there have been continuous efforts to improve the performance of these systems as they are likely to remain in use for many years to come. The introduction of a professional maintenance service in southern Kenya has shown an order of magnitude improvement in operational performance over community-based management, with 90% of handpump faults repaired within 3 days of being reported. One driver behind these efforts is the assumption that a more reliable water supply will lead to a reduction in water-related disease. However, it is not clear if operational improvements lead to health gains. Despite limited empirical evidence, some modeling studies suggest that even short periods of drinking contaminated water can lead to disproportionate negative health impacts.
    Objective: The aim of this study was to assess whether the improvements in operational performance from the rapid professional maintenance of rural handpumps lead to improved household health outcomes.
    Methods: From a sample of households using handpumps as their primary water source in Kwale County, Kenya, we measured the 2-week prevalence of World Health Organization-defined diarrhea in children, reported by the adult respondent for each household. We compared the rates before and after a period during which the households' handpumps were being professionally maintained. We then conducted a cross-sectional analysis, fitting logistic regression models with reported diarrhea as the dependent variable and speed of repair as the independent exposure of interest, adjusting for household socioeconomic characteristics; dwelling construction; and Water, Sanitation, and Hygiene (WASH)-related factors. We fitted an additional model to examine select interactions between covariates.
    Results: Reported diarrhea in children was lower in households whose pumps had been repaired within 24 hours (adjusted odds ratio 0.35, 95% CI 0.24-0.51). This effect was robust to the inclusion of multiple categories of covariates. No reduction was seen in households whose pump repairs took more than 24 hours. Analysis of interaction terms showed that certain interventions associated with improved WASH outcomes were only associated with reductions in diarrhea in conjunction with socioeconomic improvements.
    Conclusions: Only pump repairs consistently made within 24 hours of failure led to a reduction in diarrhea in the children of families using handpumps. While the efficacy of reduction in diarrhea is substantial, the operational challenges of guaranteeing same-day repairs limits the effectiveness of even best-in-class pump maintenance. Maintenance regimes that cannot bring handpump downtimes close to zero will struggle to generate health benefits. Other factors that reduce diarrhea prevalence have limited effect in isolation, suggesting that WASH interventions will be more effective when undertaken as part of more holistic poverty-reduction efforts.
    MeSH term(s) Adult ; Child ; Humans ; Cross-Sectional Studies ; Kenya/epidemiology ; Morbidity ; Diarrhea/epidemiology ; Diarrhea/prevention & control ; Water
    Chemical Substances Water (059QF0KO0R)
    Language English
    Publishing date 2024-01-16
    Publishing country Canada
    Document type Journal Article
    ISSN 2369-2960
    ISSN (online) 2369-2960
    DOI 10.2196/42462
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  3. Article ; Online: A Multiscale Spatiotemporal Epidemiological Analysis of Neighborhood Correlates of Triple-Negative Breast Cancer.

    Goldfinger, Erica / Stoler, Justin / Goel, Neha

    Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology

    2023  Volume 33, Issue 2, Page(s) 279–287

    Abstract: Background: Women living in disadvantaged neighborhoods present with increased prevalence rates of triple-negative breast cancer (TNBC). This study takes a spatiotemporal epidemiological approach to understand the impact of socioenvironmental contextual ...

    Abstract Background: Women living in disadvantaged neighborhoods present with increased prevalence rates of triple-negative breast cancer (TNBC). This study takes a spatiotemporal epidemiological approach to understand the impact of socioenvironmental contextual factors on TNBC prevalence rates.
    Methods: We analyzed 935 TNBC cases from a major cancer center registry, between 2005 and 2017, to explore spatial and space-time clusters of TNBC prevalence rates at the census tract and neighborhood scales. Spatial regression analysis was performed to examine relationships between nine socioenvironmental factors and TNBC prevalence rates at both ecological scales.
    Results: We observed spatial clustering of high TNBC prevalence rates along a north-south corridor of Miami-Dade County along Interstate 95, a region containing several majority non-Hispanic Black neighborhoods. Among the ecologic measures, the percent of a region designated as a brownfield was associated with TNBC prevalence rates at the tract-level (β = 4.27; SE = 1.08; P < 0.001) and neighborhood-level (β = 8.61; SE = 2.20; P < 0.001).
    Conclusions: Our spatiotemporal analysis identified robust patterns of hot spots of TNBC prevalence rates in a corridor of several disadvantaged neighborhoods in the northern half of the county. These patterns of TNBC align with the literature regarding at-risk groups and neighborhood-level effects on TNBC; however, remain to be validated in a population-based sample.
    Impact: Spatial epidemiological approaches can help public health officials and cancer care providers improve place-specific screening, patient care, and understanding of socioenvironmental factors that may shape breast cancer subtype through gene-environment and epigenetic interactions.
    MeSH term(s) Female ; Humans ; Black People ; Florida ; Spatial Analysis ; Spatio-Temporal Analysis ; Triple Negative Breast Neoplasms/epidemiology ; Neighborhood Characteristics ; Social Determinants of Health
    Language English
    Publishing date 2023-11-16
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 1153420-5
    ISSN 1538-7755 ; 1055-9965
    ISSN (online) 1538-7755
    ISSN 1055-9965
    DOI 10.1158/1055-9965.EPI-22-1255
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  4. Book: Spatial inequalities

    Weeks, John R. / Hill, Alan G. / Stoler, Justin

    health, poverty, and place in Accra, Ghana

    (GeoJournal library ; 110)

    2013  

    Author's details John R. Weeks ; Allan G. Hill ; Justin Stoler ed
    Series title GeoJournal library ; 110
    Geojournal
    Collection Geojournal
    Keywords Ghana ; Accra ; Wohnen ; Wohnungspolitik ; Stadtentwicklung ; Demographie ; Armut ; Gesundheit ; Ungerechtigkeit
    Subject Soziale Ungerechtigkeit ; Gesundheitsstatus ; Gesundheitszustand ; Arme Leute ; Armer ; Besitzloser ; Verarmung ; Bevölkerungskunde ; Bevölkerungswissenschaft ; Bevölkerungsforschung ; Demografie ; Stadt ; Wohngewohnheit ; Wohnverhältnisse ; Wohnverhalten ; Wohnweise
    Language English
    Size X, 219 S. : Ill., graph. Darst., Kt.
    Publisher Springer
    Publishing place Dordrecht u.a.
    Publishing country Netherlands
    Document type Book
    HBZ-ID HT017698216
    ISBN 978-94-007-6731-7 ; 9789400767324 ; 94-007-6731-5 ; 9400767323
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    2013 A 1618 available for loan (reading room) Lesesaal EG

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  5. Article ; Online: The Impact of Rapid Handpump Repairs on Diarrhea Morbidity in Children

    Patrick Thomson / Justin Stoler / Michelle Byford / David J Bradley

    JMIR Public Health and Surveillance, Vol 10, p e

    Cross-Sectional Study in Kwale County, Kenya

    2024  Volume 42462

    Abstract: BackgroundHandpumps are used by millions of people as their main source of water. Although handpumps represent only a basic form of water provision, there have been continuous efforts to improve the performance of these systems as they are likely to ... ...

    Abstract BackgroundHandpumps are used by millions of people as their main source of water. Although handpumps represent only a basic form of water provision, there have been continuous efforts to improve the performance of these systems as they are likely to remain in use for many years to come. The introduction of a professional maintenance service in southern Kenya has shown an order of magnitude improvement in operational performance over community-based management, with 90% of handpump faults repaired within 3 days of being reported. One driver behind these efforts is the assumption that a more reliable water supply will lead to a reduction in water-related disease. However, it is not clear if operational improvements lead to health gains. Despite limited empirical evidence, some modeling studies suggest that even short periods of drinking contaminated water can lead to disproportionate negative health impacts. ObjectiveThe aim of this study was to assess whether the improvements in operational performance from the rapid professional maintenance of rural handpumps lead to improved household health outcomes. MethodsFrom a sample of households using handpumps as their primary water source in Kwale County, Kenya, we measured the 2-week prevalence of World Health Organization–defined diarrhea in children, reported by the adult respondent for each household. We compared the rates before and after a period during which the households’ handpumps were being professionally maintained. We then conducted a cross-sectional analysis, fitting logistic regression models with reported diarrhea as the dependent variable and speed of repair as the independent exposure of interest, adjusting for household socioeconomic characteristics; dwelling construction; and Water, Sanitation, and Hygiene (WASH)-related factors. We fitted an additional model to examine select interactions between covariates. ResultsReported diarrhea in children was lower in households whose pumps had been repaired within 24 hours (adjusted odds ratio 0.35, 95% CI ...
    Keywords Public aspects of medicine ; RA1-1270
    Subject code 360 ; 380
    Language English
    Publishing date 2024-01-01T00:00:00Z
    Publisher JMIR Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article: Frontiers of household water insecurity metrics: severity, adaptation and resilience.

    Stoler, Justin / Jepson, Wendy E / Brewis, Alexandra / Wutich, Amber

    BMJ global health

    2023  Volume 8, Issue 5

    Abstract: The measurement of household-level and individual-level water insecurity has accelerated over the past 5 years through innovation and dissemination of new survey-based experiential psychometric scales modelled after food insecurity scales. These measures ...

    Abstract The measurement of household-level and individual-level water insecurity has accelerated over the past 5 years through innovation and dissemination of new survey-based experiential psychometric scales modelled after food insecurity scales. These measures offer needed insight into the relative frequency of various dimensions of water problems experienced by households or individuals. But they currently tell us nothing about the severity of these experiences, mitigating behaviours (ie, adaptation) or the effectiveness of water-related behaviours (ie, resilience). Given the magnitude of the global challenge to provide water security for all, we propose a low-cost, theoretically grounded modification to common water insecurity metrics in order to capture information about severity, adaptation and resilience. We also discuss ongoing challenges in cost-effective measurement related to multidimensionality, water affordability and perception of water quality for maximising the impact and sustainability of water supply interventions. The next generation of water insecurity metrics promises better monitoring and evaluation tools-particularly in the context of rapid global environmental change-once scale reliability across diverse contexts is better characterised.
    MeSH term(s) Humans ; Reproducibility of Results ; Benchmarking ; Water Insecurity ; Water Supply ; Surveys and Questionnaires
    Language English
    Publishing date 2023-05-01
    Publishing country England
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ISSN 2059-7908
    ISSN 2059-7908
    DOI 10.1136/bmjgh-2023-011756
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  7. Article ; Online: Regional Disparities in Pediatric Uveitis Care Availability in the United States.

    Choudhury, Anjalee / Stuart, Eliza / Stoler, Justin / Vu, Daniel M / Chang, Ta Chen

    Ophthalmology

    2023  Volume 130, Issue 10, Page(s) 1099–1101

    MeSH term(s) Child ; United States/epidemiology ; Humans ; Uveitis/epidemiology ; Uveitis/therapy ; Retrospective Studies
    Language English
    Publishing date 2023-05-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 392083-5
    ISSN 1549-4713 ; 0161-6420
    ISSN (online) 1549-4713
    ISSN 0161-6420
    DOI 10.1016/j.ophtha.2023.05.025
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  8. Article ; Online: Reply.

    Chang, Ta Chen / Stoler, Justin

    American journal of ophthalmology

    2019  Volume 207, Page(s) 428

    MeSH term(s) Precision Medicine
    Language English
    Publishing date 2019-08-13
    Publishing country United States
    Document type Letter ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 80030-2
    ISSN 1879-1891 ; 0002-9394
    ISSN (online) 1879-1891
    ISSN 0002-9394
    DOI 10.1016/j.ajo.2019.06.029
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  9. Article ; Online: Envirotyping: The Next Leap Forward in the Practice of Precision Medicine?

    Chang, Ta Chen / Stoler, Justin

    American journal of ophthalmology

    2019  Volume 202, Page(s) xi–xiii

    MeSH term(s) Biomedical Research ; Environment ; Humans ; Ophthalmology/methods ; Politics ; Precision Medicine/standards ; United States
    Language English
    Publishing date 2019-06-04
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural
    ZDB-ID 80030-2
    ISSN 1879-1891 ; 0002-9394
    ISSN (online) 1879-1891
    ISSN 0002-9394
    DOI 10.1016/j.ajo.2019.05.013
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  10. Article ; Online: Water Supply Interruptions Are Associated with More Frequent Stressful Behaviors and Emotions but Mitigated by Predictability: A Multisite Study.

    Thomson, Patrick / Pearson, Amber L / Kumpel, Emily / Guzmán, Danice B / Workman, Cassandra L / Fuente, David / Wutich, Amber / Stoler, Justin

    Environmental science & technology

    2024  Volume 58, Issue 16, Page(s) 7010–7019

    Abstract: Water supply interruptions contribute to household water insecurity. Unpredictable interruptions may particularly exacerbate water insecurity, as uncertainty limits households' ability to optimize water collection and storage or to modify other coping ... ...

    Abstract Water supply interruptions contribute to household water insecurity. Unpredictable interruptions may particularly exacerbate water insecurity, as uncertainty limits households' ability to optimize water collection and storage or to modify other coping behaviors. This study used regression models of survey data from 2873 households across 10 sites in 9 middle-income countries to assess whether water supply interruptions and the predictability of interruptions were related to composite indicators of stressful behaviors and emotional distress. More frequent water service interruptions were associated with more frequent emotional distress (β = 0.49, SE = 0.05,
    MeSH term(s) Humans ; Water Supply ; Emotions ; Family Characteristics ; Water Insecurity
    Language English
    Publishing date 2024-04-10
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1520-5851
    ISSN (online) 1520-5851
    DOI 10.1021/acs.est.3c08443
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