Medicine and Health Sciences Commons^™

Gender Differences In Episodic Memory In Later Life: The Mediating Role Of Education, Sara Robinson

USF Tampa Graduate Theses and Dissertations

In the United States (U.S.), 14 million individuals aged 65+ are expected to be diagnosed with dementia by 2060, and women are nearly twice as likely to be diagnosed. Low education is a well-established risk factor for dementia and is hypothesized to partly explain the gender differences in late-life cognition. However, few studies have investigated education as a mediator of these gender differences. This study aims to investigate education as a mediator of gender differences in episodic memory using longitudinal data from the U.S. Health and Retirement Study (HRS). I used a sample of 35,721 respondents (20,190 women and 15,531 …

A Healthcare Claims Investigation Of Parasomnia Epidemiology, Associations With Attention Deficit/Hyperactivity Disorder, And Rem Sleep Behavior Disorder Correlates, Anh Thy Ha Nguyen

USF Tampa Graduate Theses and Dissertations

Parasomnias, such as sleepwalking and nightmare disorder, are abnormal behaviors and emotions emanating from sleep or wake to sleep transitions. Parasomnias can lead to significant adverse outcomes – sleepwalking can result in injuries and hospitalizations, frequent nightmares are associated with self-harm and suicidal thoughts, and rapid-eye movement (REM) sleep behavior disorder (RBD) is linked to neurodegeneration. Despite a history of fascination with abnormal sleep behaviors in the general and medical communities, epidemiologic understanding of parasomnias remains limited, in part due to their amnestic nature and presumption that they are benign childhood problems. This work used the MarketScan® Commercial Claims and …

Diet And Salivary Microbiome On Cardiovascular Risk And Glycemic Control In Participants With And Without Type 1 Diabetes: The Cacti Study, Tiantian Pang

USF Tampa Graduate Theses and Dissertations

Introduction: The prevalence of type 1 diabetes mellitus (T1DM) has been increasing drastically in the United States. People with T1DM are at a higher risk of developing diabetes-related complications, including cardiovascular disease (CVD). Diet is one of the most modifiable factors and healthy eating could reduce CVD risk among individuals with T1DM. The current 2015-2020 Dietary Guidelines for Americans focus on overall healthy eating patterns rather than individual foods and nutrients. A healthy dietary pattern or high-quality diet can be measured by diet quality indexes, and generally contains minimal ultra-processed foods (UPF). Although substantial evidence has linked poor diet quality …

Nonparametric Estimation Of Transition Probabilities In Illness-Death Model Based On Ranked Set Sampling, Ying Ma

USF Tampa Graduate Theses and Dissertations

The ranked set sampling (RSS) design is applied widely in agriculture, environmental science, and medical research where the exact measurements of sampling units is costly, but sampling units can be ranked by a correlated concomitant variable. RSS is usually a cost-efficient alternate to simple random sampling (SRS) for selecting more representative samples. This study presents a novel methodology to investigate the nonparametric estimation of transition probabilities in illness-death model using the RSS design. We study the Aalen–Johansen estimator of transition probabilities in illness-death Markov model based on RSS design under random right censoring time and propose nonparametric estimators of the …

Serious Mental Illness In Nursing Homes: Quality Concerns, Dylan J. Jester

USF Tampa Graduate Theses and Dissertations

Objective: This dissertation is made of two academic papers followed by a chapter discussing policy implications of the findings. The objective of this dissertation is to better understand if high-serious mental illness (SMI) nursing homes (NHs) provide poorer quality of care (e.g., operationalized as staffing levels, NH Compare quality star ratings, and health deficiencies) and whether quality in high-SMI NHs is confounded by payer mix (e.g., the proportion of residents who are Medicaid-reimbursed). A modified Donabedian Structure, Process, Outcome (SPO) Model was used as the main theoretical framework.

Methods: Data came from the Certification and Survey Provider Enhanced Reports (CASPER) …

Mechanisms And Mitigation: Effects Of Light Pollution On West Nile Virus Dynamics, Meredith E. Kernbach

USF Tampa Graduate Theses and Dissertations

Light pollution, or the presence of unnatural light at night, is a pervasive and growing problem across the globe. While often pictured in urban centers, light pollution is far reaching and can affect seemingly safe and minimally developed environments. For example, agricultural communities with artificial lighting near facilities can generate such light pollution in rural areas. Further, streetlights and illuminated billboards along roads and highways can generate light pollution far from cities. Given how pervasive this anthropogenic stressor is, it is surprising that not much is known about how artificial light at night, or ALAN, affects humans or wildlife, especially …

Sleep Diagnoses And Low Back Pain In U.S. Military Veterans, Kenneth A. Taylor

USF Tampa Graduate Theses and Dissertations

Low back pain (LBP) is a common problem that is the primary contributor to years lived with disability worldwide. In the U.S. LBP is disproportionately experienced by military veterans. In recent years interest has grown in the impact of sleep and sleep-related diagnoses on musculoskeletal pain complaints (including LBP) and despite growth in the scientific literature investigating this, gaps in our understanding of how sleep diagnoses impact LBP remain. To that end, this dissertation uses administrative electronic health record data from veterans seeking care through the Veterans Health Administration in three manuscripts to address the following specific aims: (1) investigate …

Bait-And-Kill: Targeting A Novel Heme Biochemical Pathway In Hundreds Of Cancers, Christopher G. Marinescu

USF Tampa Graduate Theses and Dissertations

Cancer cells are characterized by their ability to grow and proliferate in rates that far exceed normal cells by modifying their iron/heme metabolisms to levels higher than normal. This imbalance of heme biosynthesis can lead to cancer cells having a flux of heme intermediates to the point where they enter a state called heme-overdrive. Heme-overdrive is a process unique to a variety of cancers but absent in normal tissues. With this enhanced production, heme can act as an epigenic regulator for signaling proliferation (18). Through the novel strategy called ‘bait-and-kill,’ cancer cells will be coerced into a state of heme …

Quantifying The Impact Of Chronic Stress On Racial Disparities In Cardiovascular Disease, Nnadozie Emechebe

USF Tampa Graduate Theses and Dissertations

Background: Despite declining mortality in cardiovascular diseases (CVD), racial disparities between non-Hispanic Blacks (NHB) and to non-Hispanic Whites (NHW) persist. Although the prevalence of traditional risk factors of CVD such as hypertension, is higher in NHB compared to NHW, adjusting for this difference does not eliminate the disparity completely. This suggests other factors might explain the persisting disparities. Thus, the purpose of this dissertation is to quantify the impact of chronic stress in explaining the racial disparities in cardiovascular diseases (CVD). This dissertation contains three studies that addressed the following Specific Aims: Specific aims: 1) To create and assess the …

A Review Of American College Campus Tobacco Or Smoke Free Policies: A Case Study Of A Large Urban University, Sarah E. Powell

USF Tampa Graduate Theses and Dissertations

Objective: A year after a tobacco free policy was passed, the University of South Florida (USF) was interested in the overall policy opinions and efficacy. To assess this a project was completed that included a survey and geospatial data. The survey measured tobacco policy enforcement behavior and a geographic information system (GIS) mapped tobacco policy violation. This project introduces an evaluation process that can efficiently assess an institutions tobacco-free policy. Methods: Using a cross-sectional survey sent to students, faculty, and staff, understanding of policy and resources, tobacco use observations, stage of change regarding policy enforcement, self-efficacy to enforce, and perceived …

Covid-19 And Quantitative Literacy: Focusing On Probability, Michael A. Lewis

Numeracy

The COVID-19 pandemic is arguably the worst crisis the world has faced, so far, in this new century. We haven’t seen a pandemic like this since the 1918 Flu at the beginning of the last century, and, as of this writing, there appears to be no end in sight. What those of us who’re focused on quantitative methods have noticed, in addition to the many people dying, becoming ill, and losing their livelihoods, is the importance of quantitative literacy to an understanding of what’s going on. That’s what this article is about. Specifically, it’s about how the COVID-19 pandemic is …

From R0 To The Herd: A Review Of The Rules Of Contagion, By Adam Kucharski, Nathan D. Grawe

Numeracy

Adam Kucharski. 2020. The Rules of Contagion: Why Things Spread--and Why They Stop; (London: Profile Books, Ltd.). Hardback ISBN 978-17-88-16019-3. E-book ISBN 978-17-82-83430-4.

Kucharski's well-timed Rules of Contagion provides an introduction to the mathematical and epidemiological principles behind contagious phenomenon. While the author's primary expertise stems from work on biological epidemics, the book points to examples from a wide range of fields including finance, psychology, computer science, and criminology. As such, selections of the book could be used by faculty in a wide range of classes to show how our recent experience with a viral epidemic might add to …

Non-Invasive Sex Determination And Genotyping Of Transgenic Brugia Malayi Larvae, Santiago E. Hernandez Bojorge

USF Tampa Graduate Theses and Dissertations

Lymphatic filariasis is a very painful and disfiguring helminth disease caused by the tissue nematodes Wuchereria bancrofti, Brugia malayi, and Brugia timori. This parasitosis is considered a Neglected Tropical Disease and it is a major public health burden for 72 tropical countries of Africa, Southeast Asia, the Caribbean, and South America. Despite the effectiveness of many control programs, there remains the need to develop new pharmacological agents to treat lymphatic filariasis, as most programs rely on a limited variety of drugs that are expensive, logistically difficult to obtain, and can lead to drug resistance. The Clustered Regularly Interspaced Short Palindromic …

The Covid-19 Pandemic And The Power Of Numbers, Jessica Ancker

Numeracy

The COVID-19 pandemic has produced a deluge of news coverage of quantitative concepts. In this viewpoint, we provide examples of effective and poor quantitative communication by the professional news media as well as social media communicators. Effective examples include a number of online animations and engaging interactive simulations. Examples of poor quantitative communication include the widespread reporting of raw numbers rather than rates, failing to address uncertainty, not providing sufficient context for numbers, and not discussing the implications of false negative and false positive diagnostic test results. Educators can draw from this body of news to develop compelling quantitative literacy …

Does Gestational Diabetes Mellitus Increases The Risk Of Preeclampsia Among Primigravid Women?, Astha Kakkad

USF Tampa Graduate Theses and Dissertations

Gestational diabetes mellitus (GDM) and preeclampsia are serious complications of pregnancy which are associated with both short- and long-term adverse health outcomes for the mother as well as the fetus. The increase in prevalence of these conditions has become a major public health concern. The purpose of this study is to examine the association and risk imposed by GDM for preeclampsia in primigravid women. This descriptive study was conducted using data retrieved from the electronic medical records of a large integrated health system in Florida. The data for this analysis included pregnancy records for patients at least 18 years of …

Identifying Barriers And Facilitators To Improve Hepatitis C Virus Screening, Linh M. Duong

USF Tampa Graduate Theses and Dissertations

Background: Birth cohort hepatitis C Virus (HCV) screening recommendations were issued by the Centers for Disease Control and Prevention (CDC) and United States Preventive Services Task Force (USPSTF) in 2012 and 2013, respectively. Despite this, studies have reported low HCV screening rates. Currently, the prevalence of HCV screening rates nationally is unknown and there are no in-depth studies that have evaluated the barriers or facilitators of HCV screening. Our study aimed to fill this gap by 1) conducting a systematic literature review to assess the national HCV screening prevalence, 2) evaluating temporal trends in HCV screening using a large academic …

The Relationship Between Continuous Glucose Monitor (Cgm) Derived Metrics And Indices Of Glycemic Control, Ryan Bailey

USF Tampa Graduate Theses and Dissertations

Introduction: Both hypoglycemia (low blood glucose) and hyperglycemia (high blood glucose) are common among individuals with type 1 diabetes and are associated with severe medical complications, therefore it is essential that health care providers are able to accurately measure glycemic control. Measures derived from continuous glucose monitoring (CGM) may provide more accurate measurements of glycemia than the commonly used HbA1c blood test.

Methods: Data from the Juvenile Diabetes Research Foundation (JDRF) clinical trial to assess the efficacy of continuous glucose monitoring was used to estimate the ability of CGM composite scores to predict time in range, time in hyperglycemia and …

Mitigating Barriers To Chronic Disease Risk Factor Prevention And Management In Disadvantaged Communities, Krys M. Johnson

USF Tampa Graduate Theses and Dissertations

Background: The incidence and prevalence of chronic disease (CD) has increased in recent decades due to the advent of CD management and life-extending technologies. To address this burden on the population and healthcare system, evidence-based CD prevention programs have been developed to reduce the incidence and therefore the prevalence of these diseases. Despite the development and dissemination of effective interventions, African-Americans and Hispanics have disproportionately higher prevalence of CD and associated risk factors and disproportionately lower participation in CD prevention programs. Overweight/obesity and CDs may have intergenerational effects, with overweight adults being more likely to have overweight children who are …

Evolutionary Dynamics Of Influenza Type B In The Presence Of Vaccination: An Ecological Study, Lindsey J. Fiedler

USF Tampa Graduate Theses and Dissertations

Understanding the evolutionary dynamics of influenza type B in human hosts is a public health concern as we strive to minimize the disease burden in seasonal epidemics. Vaccination is considered the best defense against contracting influenza, and everyone over the age of 6 months is advised to get vaccinated before each season. The effect that vaccine-acquired immunity has on the evolution of influenza B remains unclear. In the U.S., vaccine-uptake is irregular across the states, and the differing coverages present an opportunity to study how vaccination influences viral evolution. This thesis analyzes the evolutionary patterns of influenza B in the …

A Retrospective Study Of The Opioid Epidemic And Fentanyl Related Overdose Fatality Cases In A Florida West Coast Medical Examiner District Population, Anne Terese Powell

USF Tampa Graduate Theses and Dissertations

Opioids are scheduled by the propensity for misuse and abuse with a high rate of dependency and risk of fatal overdose. Opioids can be divided into different classes, including, natural, synthetic, and semi-synthetic. Opiates are naturally occurring and come directly from the opium poppy plant; whereas the semi synthetics opioids are chemical modifications of the poppy plant. Synthetic opioids attach to the opioid receptor but contain no part of the poppy plant. The increased variety and frequency in opioid prescriptions contributed to an opioid epidemic in the United States which is still on going.

According to the CDC, the opioid …

Effects Of Medications With Anticholinergic Properties And Opioids On Cognitive Function And Neural Volumetric Changes In Elderly Australians, Malinee Neelamegam

USF Tampa Graduate Theses and Dissertations

Introduction: Multiple comorbidities are common among older adults. Pharmaceutical interventions are the most common form of medical management of the multiple health conditions that the older adult population faces. Almost 90% of adults aged 65 years and above take at least one prescription medication. Polypharmacy (5 medication or more) occurs with 50% of the older adult population. Most medications used to treat common ailments affecting the geriatric population have anticholinergic properties. These medications are known to cause a range of side effects from peripheral effects to central nervous system effects. These adverse effects are of particular concern in the older …

Respiratory Infections And Risk For Development Of Narcolepsy: Analysis Of The Truven Health Marketscan Database (2008 To 2010) With Additional Assessment Of Incidence And Prevalence, Darren Scheer

USF Tampa Graduate Theses and Dissertations

Background and Significance: Narcolepsy is a chronic neurological disorder. These patients experience various psychiatric and physical comorbid diseases and mortality at an increased rate compared to the general population. Additionally, patients with narcolepsy experience approximately a doubling of various annual healthcare related facility visits, transactions, and costs comparatively. Narcolepsy with cataplexy is generally believed to be more prevalent than narcolepsy without cataplexy. However, incidence and prevalence estimates of narcolepsy (with or without cataplexy) vary widely with few large epidemiological studies conducted worldwide and none in the U.S evaluating these proportions in both children and adults utilizing a large health care …

Impact Of Obesity And Expression Of Obesity-Related Genes In The Progression Of Prostate Cancer In African American Men, Mmadili Nancy Ilozumba

USF Tampa Graduate Theses and Dissertations

In the US, the incidence and mortality rates of prostate cancer (PCa) are higher among African American men compared to European American men. Obesity is an important risk factor of PCa. Obesity is known to alter the gene expression profiles in prostate tumors. This study evaluates the impact of obesity and the expression of obesity-related genes on the progression of PCa in African American men.

The primary outcome of interest is biochemical recurrence (BCR) of PCa. There were 48 African American prostate cancer patients in the study. The tissue samples included 42 normal tissues, 40 Prostate Intraepithelial Neoplasia (PIN) and …

Angiostrongylus Cantonensis: Epidemiologic Review, Location-Specific Habitat Modelling, And Surveillance In Hillsborough County, Florida, U.S.A., Brad Christian Perich

USF Tampa Graduate Theses and Dissertations

Angiostrongylus cantonensis is a parasitic nematode endemic to tropical and subtropical regions and is the leading cause of human eosinophilic meningitis. The parasite is commonly known as rat lungworm because the primary host in its lifecycle is the rat. A clinical overview of rat lungworm infection is presented, followed by a literature review of rat lungworm epidemiology, risk factors, and surveillance projects. Data collected from previous snail surveys in Florida was considered alongside elevation, population per square kilometer, median household income by zip code territory, and normalized difference vegetation index specific to the geographic coordinates from which the snail samples …

Sleep And Alzheimer’S Disease: A Critical Examination Of The Risk That Sleep Problems Or Disorders Particularly Obstructive Sleep Apnea Pose Towards Developing Alzheimer’S Disease, Omonigho A. Michael Bubu

USF Tampa Graduate Theses and Dissertations

This dissertation is a critical examination of the relationship between sleep problems and/or disorders, particularly Obstructive Sleep Apnea (OSA) and Alzheimer Disease (AD). First, I conducted an exhaustive systematic review of existing literature, and identified gaps in research that led to specific research aims. For the first aim, I conducted the first ever-published meta-analysis examining sleep, cognitive decline and AD, providing an aggregate effect of sleep on AD. Second, focusing on OSA, I conducted a study examining OSA’s effect on longitudinal changes on AD biomarkers in cognitive normal, MCI and AD subjects, using data from the Alzheimer Disease Neuroimaging Initiative …

Ambient Ozone And Cadmium As Risk Factors For Congenital Diaphragmatic Hernia, Rema Ramakrishnan

USF Tampa Graduate Theses and Dissertations

Congenital diaphragmatic hernia (CDH) results from a defect in the diaphragm through which abdominal contents enter the thorax displacing the heart and the lungs. This causes lung hypoplasia and varying degrees of pulmonary hypertension resulting in high rates of morbidity and mortality. Though CDH has a prevalence rate of 2.61 per 10,000 live births it is an expensive birth defect with an estimated annual cost of nearly $250 million for all CDH survivors. Maternal exposure to air pollutants have not been studied as risk factors for CDH in humans. Ambient ozone has been found to be risk factors for certain …

The Effects Of Maternal Folate On Fetal Brain And Body Size Among Smoking Mothers, Korede K. Adegoke

USF Tampa Graduate Theses and Dissertations

The adverse effects of maternal smoking on infant mortality and morbidity has been well documented in the literature. Maternal tobacco use is causally associated with fetal growth restriction and correlates negatively with folate intake and metabolism. Studies have examined the association between smoking and folate levels during pregnancy, but very few have assessed this relationship using objective and accurate measures of both variables. Furthermore, despite evidence of a causal association between smoking in pregnancy and intrauterine growth restriction, and a plausible relationship between tobacco use and low maternal folate which is required for optimal fetal growth, no experimental study has …

Ambient Benzene And Pm2.5 Exposure During Pregnancy: Examining The Impact Of Exposure Assessment Decisions On Associations Between Birth Defects And Air Pollution, Jean Paul Tanner

USF Tampa Graduate Theses and Dissertations

In the United States, approximately 3% of infants are diagnosed with a major birth defect each year. Whereas prevention efforts have led to decreases in some birth defects, the cause of approximately 70% of birth defects remains unknown. More recently, there has been increasing concern regarding exposures to environmental agents, such as air pollution during pregnancy, and the risk of birth defects. Over the past decade, there has been an increase in research studies examining the association between air pollution and birth defects. The results have been inconsistent, with some studies reporting that higher levels of exposure from the same …

Deployment, Post-Traumatic Stress Disorder And Hypertensive Disorders Of Pregnancy Among U.S. Active-Duty Military Women, Michelle C. Nash

USF Tampa Graduate Theses and Dissertations

Introduction. Today women comprise 15% of the U.S. active-duty military, but are often overlooked in research of the Armed Forces. While some of the challenges faced by women are similar to men, they encounter unique stressors related to childcare while deployed, sexual harassment and assault, and gynecological needs. Women are also more likely than men to develop post-traumatic stress disorder (PTSD). Both stress and PTSD have been linked to the development of chronic hypertension and some adverse birth outcomes. We hypothesized that post-9/11/2001 era military women who deployed or who had indicators of PTSD would be at greater risk of …

Severe Maternal Morbidity In Florida: Risk Factors And Determinants Of The Increasing Rate, Lindsay Shively Womack

USF Tampa Graduate Theses and Dissertations

Severe maternal morbidity generally refers to the most severe complications of pregnancy and includes: hemorrhage, embolism, acute renal failure, stroke, acute myocardial infarction, and other complications. These complications affect more than 50,000 women in the United States every year, with rates significantly increasing from 1998 to 2011. In an effort to reduce these increasing complication rates, clinicians and researchers have emphasized the need to identify potential modifiable risk factors for severe maternal morbidity, and the need to study the relationships between these risk factors and severe maternal morbidity. The overall goal of this study is to improve the understanding of …