Medicine and Health Sciences Commons^™

Effect Of Primary Care Physician Density On Late Stage Cervical Cancer Diagnosis, Emily Haanschoten

Theses and Dissertations

INTRODUCTION: Late-stage cervical cancer diagnosis is an important contributing factor to the cervical cancer mortality rate. Screening for cervical cancer is a vital tool in reducing the number of late-stage cases, preventing incident cases and reducing mortality. Access to care is often a significant barrier to receiving these services. Women who have no usual source of care report significantly lower percentages of Pap tests than women who have a usual source. South Carolina ranks 13th in the US in cervical cancer incidence and 7th in cervical cancer mortality. South Carolina also struggles with a primary care physician shortage, ranking 39th …

Assessing The Social And Ecological Factors That Influence Childhood Overweight And Obesity, Katie Callahan

Electronic Theses and Dissertations

The prevalence of childhood overweight and obesity is increasing at an alarming rate in the United States. Currently more than 1 in 3 children aged 2-19 are overweight or obese. This is of major concern because childhood overweight and obesity leads to chronic conditions such as type II diabetes and tracks into adulthood, where more severe adverse health outcomes arise. In this study I used the premise of the social ecological model (SEM) to analyze the common levels that a child is exposed to daily; the intrapersonal level, the interpersonal level, the school level, and the community level to better …

Nutritional, Hormonal, And Psychological Risk Factors For Breast Cancer, Susan Nicole Boyer Brown

Doctoral Dissertations

Over the course of a lifetime, one in eight women will develop breast cancer. To date, 30-40% of breast cancer cases can be attributed to established risk factors, which supports the need for identification of additional modifiable risk factors. Therefore, we conducted three epidemiologic studies to examine the associations between nutritional, hormonal, and psychological risk factors and breast cancer risk. In our first study, we examined the relationship between urinary melatonin levels and the risk of breast cancer in a nested-case control study within the Nurses’ Health Study II. While limited in some respects, experimental and epidemiologic evidence support the …

Risk Factors For Recurrent Major Depressive Disorder In A Nationally Representative Sample, Graig Charles Defeo

USF Tampa Graduate Theses and Dissertations

The public use version of the National Comorbidity Survey - Replication (NCS-R) dataset was used (N = 995) to investigate risk factors for recurrent major depressive disorder (MDD) that are evident before recovery from the first major depressive episode (MDE) by comparing persons diagnosed with MDD who experienced a single MDE to persons with recurrent MDD.

Multiple logistic regression analyses assessed the independent risk of recurrent MDD for each of the following risk factors: an early age of onset (old), absence of a life stress trigger, chronic first episode, childhood parental loss, parental maltreatment, parental depression, comorbid anxiety disorder, and …

Epidemiology, Determinants And Dynamics Of Cholera In Pakistan: Gaps And Prospects For Future Research., Maliha Naseer, Tanzil Jamali

Community Health Sciences

Cholera is one of the notifiable endemic diseases in Pakistan, but the reporting of cholera cases is still unsatisfactory. Most of the diagnosed cases are never reported to the relevant authorities. In the year 1993 - 2005, the country did not report any single case of cholera to the WHO. The objectives of this review were to understand the epidemiology and to identify the possible determinants of cholera infection in Pakistan. Medscape, Medline, PakMedinet and PubMed, was searched, using key words, epidemiology and determinants of cholera infection in Pakistan during 1995 - 2010. Morbidity and mortality due to cholera infection …

Successful Mdr-Tb Treatment Regimens Including Amikacin Are Associated With High Rates Of Hearing Loss, Chawangwa Modongo, Rafal S. Sobota, Boikobo Kesenogile, Ronald Ncube

Dartmouth Scholarship

Aminoglycosides are a critical component of multidrug-resistant tuberculosis (MDR-TB) treatment but data on their efficacy and adverse effects in Botswana is scarce. We determined the effect of amikacin on treatment outcomes and development of hearing loss in MDR-TB patients. Patients started on MDR-TB treatment between 2006 and 2012 were included. Multivariate analysis was used to determine the effect of amikacin on treatment outcomes and development of hearing loss.

Racial Differences In Trends And Predictors Of Infant Sleep Positioning In South Carolina, 1996-2007, Michael Smith, Jihong Liu, Kristen Helms, Kristin Wilkerson

Jihong Liu

No abstract provided.

Variability Of Fev And Criterion For Acute Pulmonary Exacerbation, Bradlee A. Jenkins, L. Lee Glenn

ETSU Faculty Works

Excerpt: Morgan et al. (1) concluded that cystic fibrosis (CF) in children and adolescents with a high baseline forced expiratory volume (FEV₁) were less likely to have a therapeutic intervention or slower rate of FEV₁ decline after a single acute decline in FEV₁ of 10%. This conclusion is not well supported due to the arbitrary criteria used for defining a pulmonary exacerbation, as explained below.

Pubh 3231 - Epidemiology And Biostatistics, John Sheahan

Jiann-Ping Hsu College of Public Health Syllabi

This course introduces the student to the principles and practice of epidemiology and vital statistics. Students will be exposed to the historical development of epidemiology, concepts of causality, definitions of health and disease, and sources of community health data. Current principles and practices in the cause, prevention and control of diseases in various community settings will be emphasized.

Enhanced Expression Of Codon Optimized Mycobacterium Avium Subsp. Paratuberculosis Antigens In Lactobacillus Salivarius, Christopher D. Johnston, John P. Bannatine, Rodney Govender, Lorraine Endersen, Daniel Pletzer, Helge Weingart, Aidan Coffey, Jim O'Mahony, Roy D. Sleator

Department of Biological Sciences Publications

It is well documented that open reading frames containing high GC content show poor expression in A+T rich hosts. Specifically, G+C-rich codon usage is a limiting factor in heterologous expression of Mycobacterium avium subsp. paratuberculosis (MAP) proteins using Lactobacillus salivarius. However, re-engineering opening reading frames through synonymous substitutions can offset codon bias and greatly enhance MAP protein production in this host. In this report, we demonstrate that codon-usage manipulation of MAP2121c can enhance the heterologous expression of the major membrane protein (MMP), analogous to the form in which it is produced natively by MAP bacilli. When heterologously over-expressed, antigenic determinants …

Constructing Representative Social Networks For Disease Simulation, Tao Yang, Mario Ventresca

The Summer Undergraduate Research Fellowship (SURF) Symposium

Diseases spread mechanisms have been questioned and studied for many years. The ability to make predictions about an epidemic could enable scientists to evaluate inoculation/ isolation plans, control the mortality rate, and prevent the future course of an outbreak. Accurate predictions, however, are extremely hard to make and requires interdisciplinary solutions from epidemiology, sociology, statistics, graph theory, and Computer Science. For making the prediction, currently few network analysis platforms written in C++ are designed and optimized. The research is aimed to address this gap by exploring methods of constructing social contact network, simulating disease spreading, and proposing mitigation strategies for …

Gpu-Accelerated Influenza Simulations For Operational Modeling, Peter Holvenstot

Masters Theses

Simulations of influenza spread are useful for decision-making during public-health emergencies. Policy-makers use models to predict disease spread and estimate the effects of various intervention strategies. Effective modeling of targeted intervention strategies requires accurate modeling of individual-level behavior and transmission. However, this greatly increases the computational costs of these agent-based models. In addition, if the models are used as an outbreak progresses, some operational decisions must occur rapidly in order to contain the spread of the disease.

Graphics Processing Units (GPUs) are a type of specialized processor used to drive graphical displays. Many recent devices also allow users to write …

A Spatial Analysis Of Functional Outcomes And Quality Of Life Outcomes After Pediatric Injury, Nathaniel Bell, Sami Kruse, Richard K. Simons, Mariana Brussoni

Faculty Publications

BACKGROUND:

Changes in health-related quality of life (HRQoL) are more regularly being monitored during the first year after injury. Monitoring changes in HRQoL using spatial cluster analysis can potentially identify concentrations of geographic areas with injury survivors with similar outcomes, thereby improving how interventions are delivered or in how outcomes are evaluated.

METHODS:

We used a spatial scan statistic designed for oridinal data to test two different spatial cluster analysis of very low, low, high, and very high HRQoL scores. Our study was based on HRQoL scores returned by children treated for injury at British Columbia Children's Hospital and discharged …

Infectious Diseases, Bert Chapman

Libraries Faculty and Staff Scholarship and Research

Provides information about the role of infectious diseases in the early years of U.S. History, with particular emphasis on how they impacted injuries sustained in military conflict.

A Comparison Of Five Malaria Transmission Models: Benchmark Tests And Implications For Disease Control, Dorothy I. Wallace, Ben S. Southworth, Xun Shi, Jonathan W. Chipman, Andrew K. Githeko

Dartmouth Scholarship

Background: Models for malaria transmission are usually compared based on the quantities tracked, the form taken by each term in the equations, and the qualitative properties of the systems at equilibrium. Here five models are compared in detail in order to develop a set of performance measures that further illuminate the differences among models.

Methods: Five models of malaria transmission are compared. Parameters are adjusted to correspond to similar biological quantities across models. Nine choices of parameter sets/initial conditions are tested for all five models. The relationship between malaria incidence in humans and (1) malaria incidence in vectors, (2) man-biting …

Hiv-Positive Parents, Hiv-Positive Children, And Hiv-Negative Children’S Perspectives On Disclosure Of A Parent’S And Child’S Illness In Kenya, Grace Gachanja, Gary J. Burkholder Jr, Aimee Ferraro

Walden Faculty and Staff Publications

HIV disclosure from parent to child is complex and challenging to HIV-positive parents and healthcare professionals. The purpose of the study was to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. Sixteen HIV-positive parents, seven HIV-positive children, and five HIV-negative children completed semistructured, in-depth interviews. Data were analyzed using the Van Kaam method; NVivo 8 software was used to assist data analysis. We present data on the process of disclosure based on how participants recommended full disclosure be approached to HIV-positive and negative children. Participants recommended disclosure as a process starting at …

The Disability Burden Associated With Stroke Emerges Before Stroke Onset And Differentially Affects Blacks: Results From The Health And Retirement Study Cohort, Benjamin D. Capistrant, Nicte I. Mejia, Sze Yan Liu, Qianyi Wang, M. Maria Glymour

Department of Public Health Scholarship and Creative Works

Background.

Few longitudinal studies compare changes in instrumental activities of daily living (IADLs) among stroke-free adults to prospectively document IADL changes among adults who experience a stroke. We contrast annual declines in IADL independence for older individuals who remain stroke-free to those for individuals who experienced a stroke. We also assess whether these patterns differ by sex, race, or Southern birthplace. Methods.

Health and Retirement Study participants who were stroke-free in 1998 (n = 17,741) were followed through 2010 (average follow-up = 8.9 years) for self- or proxy-reported stroke. We used logistic regressions to compare annual changes in odds of …

Epidemiology Of Coccidioidomycosis In Missouri, Ravi Kumar Aggu Sher

Open Access Theses

Introduction. Incidence of Coccidioidomycosis has been increasing nationally, from 2,271 cases in 1998 to 17,802 cases in 2012. Missouri is not endemic to Coccidioidomycosis but the incidence has been increasing since becoming reportable in 2003. To describe epidemiology of Coccidioidomycosis in Missouri we conducted a retrospective review of surveillance data at Missouri Department of Health & Senior Services (DHSS) for the years, 2004-2013.

Methods. Data was obtained from Missouri Health Surveillance Information System (WebSurv), the statewide reporting system for notifiable diseases. All cases that were "Confirmed" were included in the study.

Results. There were a total of 93 confirmed cases …

Cancer And Infection, Kathleen Hope Plummer

USF Tampa Graduate Theses and Dissertations

E. coli is the most frequently isolated Gram negative pathogen from bacteremia in cancer patients and is repeatedly recovered from many other extraintestinal illnesses. These infections are commonly endogenous in nature and interfere with the treatment of cancer resulting in increased healthcare costs, morbidity, and mortality rates. Cancer and the treatments related to cancer cause alterations in the microbiome of the gut and other organs. Despite this point, there is a serious lack of knowledge about the genetic types of E. coli infecting cancer patients. This gap results in vague prevention strategies and limited treatment options for cancer patients. Multi …

Dietary Habits Are Related To Outcomes In Patients With Advanced Heart Failure Awaiting Heart Transplantation, Heike Spaderna, Daniela Zahn, Johanna Pretsch, Sonja Connor, Armin Zitterman, Stefanie Schleithoff, Katrina Bramstedt, Jacqueline Smits, Gerdi Weiner

Katrina A. Bramstedt

Empirical evidence supporting the benefits of dietary recommendations for patients with advanced heart failure is scarce. We prospectively evaluated the relation of dietary habits to pretransplant clinical outcomes in the multisite observational Waiting for a New Heart Study.

Risk Factors For Posttraumatic Stress Disorder In Haitian Students, Gretel Silvestre, Pascale Anacréon, Michèle Théodore, Emmanuel Silvestre, Eugenia Garcia-Dubus

Publications and Research

The aim of this study was to assess the prevalence of posttraumatic stress disorder (PTSD) in undergraduate students after the Haiti earthquake on January 12, 2010, as well as to identify the risk factors involved in the development of PTSD symptoms in this sample. Evaluations concerning depression, anxiety, risk and protective factors, and PTSD symptoms were conducted in 246 Haitian undergraduate students enrolled in a Dominican private university. Results indicate a prevalence of 36% for PTSD 2 years after the earthquake, with a high prevalence also of depression (31.7%) and anxiety (21.1%). Some of the risk factors identified are being …

Dsm‐5 And Icd‐11 Definitions Of Posttraumatic Stress Disorder: Investigating “Narrow” And “Broad” Approaches, Dan J. Stein, Katie A. Mclaughlin, Karestan C. Koenen, Lukoye Atwoli, Matthew J. Friedman, Eric D. Hill, Andreas Maercker, Maria Petukhova, Victoria Shahly, Mark Van Ommeren

Internal Medicine, East Africa

Background: The development of the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) and ICD-11 has led to reconsideration of diagnostic criteria for posttraumatic stress disorder (PTSD). The World Mental Health (WMH) Surveys allow investigation of the implications of the changing criteria compared to DSM-IV and ICD-10.

Methods: WMH Surveys in 13 countries asked respondents to enumerate all their lifetime traumatic events (TEs) and randomly selected one TE per respondent for PTSD assessment. DSM-IV and ICD-10 PTSD were assessed for the 23,936 respondents who reported lifetime TEs in these surveys with the fully structured Composite International Diagnostic Interview …

Safety Of Infusing Rituximab At A More Rapid Rate In Patients With Rheumatoid Arthritis: Results From The Rate-Ra Study, Charles H. Pritchard, Maria W. Greenwald, Joel M. Kremer, Norman B. Gaylis, William Rigby

Dartmouth Scholarship

As recommended in the current prescribing information, rituximab infusions in patients with rheumatoid arthritis (RA) take 4.25hours for the first infusion and 3.25hours for subsequent infusions, which is a burden on patients and the health care system. We therefore evaluated the safety of infusing rituximab at a faster rate for an infusion period of 2hours in patients with RA.

Health System Characteristics And Rates Of Readmission After Acute Myocardial Infarction In The United States, Jeremiah R. Brown, Chiang-Hua Chang, Weiping Zhou, Todd A. Mackenzie, David J. Malenka, David C. Goodman

Dartmouth Scholarship

Background:

Interventions to reduce early readmissions have focused on patient characteristics and the importance of early follow‐up; however, less is known about the characteristics of health systems, including quality, capacity, and intensity, and their influence on readmission rates in the United States. Therefore, we examined the association of hospital patterns of medical care with rates of 30‐day readmission.

Methods and Results:

Medicare beneficiaries hospitalized for an AMI (n=188 611) between 2008 and 2009 in 1088 hospitals in the United States were included in our cohort. We tested the association between hospital patterns of medical care quality (discharge planning care quality), …

Which Lipid Measurement Should We Monitor? An Analysis Of The Lipid Study, Paul Glasziou, Les Irwig, Adrienne Kirby, Andrew Tonkin, R J. Simes

Paul Glasziou

Objectives: To evaluate the optimal lipid to measure in monitoring patients, we assessed three factors that influence the choice of monitoring tests: (1) clinical validity; (2) responsiveness to therapy changes and (3) the size of the long-term ‘signal-to-noise’ ratio. Design: Longitudinal analyses of repeated lipid measurement over 5 years. Setting: Subsidiary analysis of a Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) study—a clinical trial in Australia, New Zealand and Finland. Participants: 9014 patients aged 31–75 years with previous acute coronary syndromes. Interventions: Patients were randomly assigned to 40 mg daily pravastatin or placebo. Primary and secondary outcome measures: We …

A Naturalistic Study Of Screening For Eating Disorder Amongst Psychiatric Patients, Amresh Srivastava, Miky Kaushal, Megan Johnston, Robbie Campbell

Amresh Srivastava

No abstract provided.

Exome-Wide Association Study Of Endometrial Cancer In A Multiethnic Population, Maxine M. Chen, Marta Crous-Bou, Veronica W. Setiawan, Jennifer Prescott, Sarah H. Olson, Nicolas Wentzensen, Amanda Black, Louise Brinton, Chu Chen, Constance Chen, Linda S. Cook, Jennifer Doherty

Dartmouth Scholarship

Endometrial cancer (EC) contributes substantially to total burden of cancer morbidity and mortality in the United States. Family history is a known risk factor for EC, thus genetic factors may play a role in EC pathogenesis. Three previous genome- wide association studies (GWAS) have found only one locus associated with EC, suggesting that common variants with large effects may not contribute greatly to EC risk. Alternatively, we hypothesize that rare variants may contribute to EC risk. We conducted an exome-wide association study (EXWAS) of EC using the Infinium HumanExome BeadChip in order to identify rare variants associated with EC risk. …

Screening For Eating Disorder Amongst Psychiatric Patients, Amresh Srivastava, Miky Kaushal, Megan Johnston, Robbie Campbell

Amresh Srivastava

No abstract provided.

Associations Of Total Activity Counts And Physical Activity Intensity Levels With The Metabolic Syndrome: A Structural Equation Modeling Approach, Dana Lizbeth Wolff

Doctoral Dissertations

To clarify the protective benefits of physical activity (PA), epidemiologists and public health researchers continue to seek improved methods of assessing PA. In particular, accelerometers have gained acceptance with researchers as they provide reliable estimates of PA and can record both the amount and intensity of ambulatory movement. However, there is concern that accelerometer data reduction techniques may not provide quantitatively accurate measurements of time spent in various PA intensity categories. One way to circumvent these inaccuracies is to use the accelerometer-derived total activity counts (TAC), which is a more direct expression of what the monitor records.

In order to …

Factors Associated With College Students' Excessive Alcohol Consumption Within The Occupational Therapy Practice Framework: An Epidemiological Analysis, Beom-Young Cho

Theses and Dissertations

OBJECTIVE: The purpose of this study was to estimate the relative influence of predictor variables on excessive alcohol consumption among college students for providing effective prevention and intervention. Also, this study suggests the roles of occupational therapy in Health promotion and Well-being. METHOD: The data from 7,166 college students (3,176 males, 3,990 females) aged between 18 - 25 years from the 2012 National Survey on Drug Use and Health (NSDUH) conducted by the US Department of Health and Human Services was used. Two criterion variables, binge drinking and heavy drinking, were used as indicators of excessive alcohol consumption. There were …