Public Health Commons^™

Obesity Risk And Comorbidities Among Colombians In New York City And In Colombia, Carlos A. Devia

Dissertations and Theses

Introduction: The prevalence of obesity and overweight in adults and children continues to increase worldwide, accounting for the mortality and morbidity from several diseases. Obesity disproportionally impacts Latinos in the United States (U.S.), and despite their diversity in origins, ancestry, and culture, it is still unclear the burden of obesity by specific Latino groups. For example, little information is available about how obesity impacts Colombians in the U.S. (the largest South American population). New evidence also indicates that Latino immigrants may no longer be arriving with healthy weight status to the U.S. because Latin American countries are undergoing epidemiologic and …

Engagement Journalism In Action: Supporting New Yorkers With Long Covid, Sarah Luft

Capstones

What do asthma and long COVID have in common? 1 in 13 U.S. adults are living with them. This report is a recap of my efforts to address the information needs of New Yorkers with long COVID as a student in CUNY's Craig Newmark Graduate School of Journalism engagement program. For my final project, I partnered with THE CITY, a nonprofit news outlet serving New Yorkers, to expand the MISSING THEM project. The report details the what, why, and how of my engagement reporting process, including a community engagement framework, a service journalism series, and lessons to carry forward. You …

Back To The Roots: Black Veganism, Kiara R. Thomas

Capstones

Only 3% of Americans in general, but 8% of Black Americans are strict vegan or vegetarian. Whether it’s to reduce animal cruelty, manage a chronic illness, or connect with their heritage and build a social movement, Black people are embracing plant-based diets. https://kiarathomas429.github.io/portfolio/

Impact Of The Covid-19 Pandemic On The Care Continuum Of Youth Living With Hiv: Qualitative Study Of The Scale It Up Program Clinical Sites, Tyra Dark, Sitaji Gurung, Mary Dooley, Kit N. Simpson, Seyram A. Butame, Sylvie Naar

Publications and Research

The study objective was to explore the impact of COVID-19 pandemic restrictions on the clinics’ ability to provide continuous healthcare services to youth (15–24 years) living with HIV (YLWH). One focused semi-structured interview was conducted with each HIV clinic site—resulting in ten interviews. Data were analyzed using thematic analysis techniques assisted by NVIVO coding software and themes indicating barriers and facilitators to providing uninterrupted healthcare were elicited. Six themes were identified that affected the care continuum of YLWH: Timeframe of clinic preparation to address COVID-19 restrictions; impact on treatment cascade monitoring data; impact on patient care; impact on staff and …

A Novel Approach Toward Concussion Testing, Jorge K. Mercado, Ari Schacter, Danielle Euzent

Student Theses

A concussion is a violent jarring or shaking of the head caused by whiplash or direct impact that results in a disturbance of brain function. Concussions can be mild and brief, as a person may be dazed momentarily or can be more serious, resulting in a loss of consciousness. Underreporting of concussions is prevalent because they are a symptom-based diagnosis, lacking a clinical test. In this study, we investigated the use of VNG testing as a clinical diagnosis of concussions. Looking at the VNG test battery, the previous research cohort found that saccades, gaze, and positional testing are the most …

Covid-19 Vaccine Mandate, Mikhail Kun, Tatiana Ryzhakova

Publications and Research

The COVID-19 pandemic has wreaked havoc on the planet and killed millions of people. Health care workers and radiology technicians who come into direct contact with COVID-19 patients have indeed been the most affected by the virus. Since the pandemic began, the COVID-19 cases among health care workers have surged and quadrupled. COVID-19 vaccine mandate is the need of the time. Mandates have a history and are in effect for other diseases such as smallpox, measles, or mumps. But since the vaccines have come out for COVID-19, there is a public impetus to condemn these vaccines, based on the false …

Feasibility Of Using Electronic Health Records For Cascade Monitoring And Cost Estimates In Implementation Science Studies In The Adolescent Trials Network For Hiv/Aids Interventions, Tyra Dark, Kit N. Simpson, Sitaji Gurung, Amy L. Pennar, Marshall Chew, Sylvie Naar

Publications and Research

Background:One of the most difficult areas in the fight against HIV/AIDS is reaching out to youth aged 13 to 24 years. The proportion of youth living with HIV/AIDS on antiretroviral therapy (ART) and who are virally undetectable is low, highlighting significant challenges for reaching the Joint United Nations Program on HIV targets.

Objective:This study aimed to assess the feasibility of obtaining key clinical indicators and monitoring treatment, viral suppression, and retention components of the youth HIV treatment cascade in Adolescent Trials Network for HIV/AIDS Interventions clinics using electronic health record (EHR) downloads and to provide baseline characteristics for the study …

Genomic Epidemiology Of Clostridium Difficile Colonization And Transmission In An Intensive Care Unit Cohort, Brianne Ciferri

Dissertations and Theses

Abstract

Genomic epidemiology of Clostridium difficile colonization and transmission in an intensive care unit cohort

by Brianne Ciferri, MPH

Advisor: C. Mary Schooling, PhD

Introduction: Clostridiodes difficile (C. difficile) is a leading cause of healthcare associated infections (HAI) in the United States and responsible for an estimated incidence of 223,900 cases and 12,800 deaths per year^1,2. C. difficile can cause gastrointestinal illness with symptoms ranging from mild diarrheal illness to a life-threatening condition. C. difficile is an opportunistic pathogen in which spores can live in an undisturbed dormant state within the intestinal tract and become …

Exploring Social Determinants Of Covid-19 Related Sickness And Suffering In The Bronx, Hamida Chumpa

Student Theses and Dissertations

Through a positivistic and phenomenological approach, the study examines social determinants of COVID-19 related sickness and suffering in the Bronx, New York City, New York, ZIP codes 10462, 10472, 10467, 10458, 10474, and 10464. I utilize a violence paradigm (structural and everyday violence) to describe the social determinants of risk and sickness-related suffering and deploy an assemblage framework to shed light on how these determinants create negative synergies that undermine wellbeing and render certain communities vulnerable to extreme suffering. The mixed methods include 64 surveys and eight interviews. Analysis methods include a descriptive analysis of survey results and a thematic …

Understanding Of Aerosol Transmission Of Covid 19 In Indoor Environment - Part 2: Approaches To Mitigation, Adama Barro, Cathal O'Toole, Jacob S. Lopez, Matthew Quinones, Sherene Moore

Publications and Research

The challenge we face in implementing solutions for new HVAC ventilation and filtration design, is to effectively improve air quality for virus mitigation without losing performance efficiency. The purpose of this improvement is to decontaminate the occupied enclosed areas, reducing the transmission of the corona virus aerosol transmission. Our research seeks reliable approaches to mitigate the further spread of aerosol transmission in indoor spaces. The methodology is to examine innovative HVAC engineering solutions that combat epidemiological problems of Covid-19 for the post-pandemic era, by researching scholarly articles and ASHRAE journals. We are achieving the goal of finding highly efficient resolutions …

Understanding Of Aerosol Transmission Of Covid 19 In Indoor Environments, Adama Barro, Cathal O'Toole, Jacob S. Lopez, Matthew Quinones, Sherene Moore

Publications and Research

Our reason for discussing severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) or 2019 novel corona virus (Covid-19), is to understand its aerosol transmission characteristics in indoor spaces and to mitigate further spread of this disease by designing a new HVAC system. The problem that we are tackling is the spread of covid-19 droplets through aerosol transmission by looking at potential engineering solutions to the existing HVAC systems. The purpose is to eradicate the spread of the COVID-19 by testing indoor spaces in an effort to understand the effectiveness of ventilation controls. We believe that scientists and engineers have not …

Plasma Proteins That May Cause Parkinson’S Disease And Multiple Sclerosis: A Mendelian Randomization Study, Brigid A. Staley

Dissertations and Theses

Multiple sclerosis (MS) and Parkinson’s disease (PD) are progressively disabling neurologic disorders that profoundly affect quality of life and shorten life expectancy. There is no cure for either disease, and current treatments only alleviate symptoms and may cause serious side effects. The causes of MS and PD are not well understood. Previous epidemiologic studies have documented numerous environmental risk factors for both diseases. However, these studies are inherently prone to bias from confounding which may generate spurious results. The lack of unbiased evidence on environmental causes of MS and PD has been a critical barrier to fully understanding their pathophysiology. …

Impact Of 2012 Spanish Health Care Reform On Hiv-Positive Immigrants: A Mixed Methods Approach, Megi Gogishvili

Dissertations and Theses

Background: The financial crisis of 2008 hit Spain hard. As a consequence, the government took multiple austerity measures, including reforms in the healthcare system in 2012. Specifically, the government reduced the budget for health and social services by 13.7% in 2012.The reduction was further followed with structural changes via the 2012 Royal Decree Law (RDL) and Royal Decree (RD).The 2012 RDL and RD entailed broad areas of action,but most importantly the Spanish National Health System (SNS) no longer covered undocumented immigrants. The 2012 RDL and RD excluded approximately 500,000 undocumented immigrants from SNS.

The number of immigrants in Spain has …

Neuroinvasion, Neurotropic, And Neuroinflammatory Events Of Sars-Cov-2: Understanding The Neurological Manifestations In Covid-19 Patients, Yassine Yachou, Abdeslem El Idrissi, Vladimir Belapasov, Said Ait Benali

Publications and Research

Respiratory viruses are opportunistic pathogens that infect the upper respiratory tract in humans and cause severe illnesses, especially in vulnerable populations. Some viruses have neuroinvasive properties and activate the immune response in the brain.These immune events may be neuroprotective or they may cause long-term damage similar to what is seen in some neurodegenerative diseases. The new “Severe Acute Respiratory Syndrome Coronavirus 2” (SARS-CoV-2) is one of the Respiratory viruses causing highly acute lethal pneumonia coronavirus disease 2019 (COVID-19) with clinical similarities to those reported in “Severe Acute Respiratory Syndrome Coronavirus” (SARS-CoV) and the “Middle East Respiratory SyndromeCoronavirus” (MERS-CoV) including neurological …

Investigating The Impact Of The Nursing Practice Environment (Npe) On Central Line-Associated Bloodstream Infections (Clabsi) Among Older Adults In The Intensive Care Unit (Icu), Kristen A. Cribbs

Dissertations and Theses

Background: Health care–associated infections, resulting from treatment received for medical or surgical conditions in a health care setting, represent a critical public health and patient safety issue, exacting substantial medical, social, and economic costs. The costliest among the leading causes of preventable health care-associated infections is central-line associated bloodstream infections (CLABSI), to which older adults (age 65 years and older) are particularly susceptible, especially during intensive care unit (ICU) stays. A rich body of research has empirically linked the quality of the nursing practice environment (NPE) in hospitals to both positive and negative patient outcomes; yet, surprisingly few studies have …

Impacts Of Rift Valley Fever Virus: A One Health Approach To Assess Burden And Inform Prevention And Control Options, Catherine Machalaba

Dissertations and Theses

Background: Rift Valley Fever (RVF) is a climate-sensitive emerging zoonotic disease associated with large-scale livestock production losses and human disease burden in Sub-Saharan Africa and the Middle East. While recognized as a key One Health issue based on its transmission dynamics involving human, animal and environmental determinants, there has been poor coordination between sectors to reduce the risk and impact of RVF. Efforts to counter the disease remain largely reactive, presenting an ongoing threat to local and global health security. The intent of this dissertation was to improve understanding of the burden of RVF across society and to identify entry …

Exploration Of The Complex Relationship Among Multilevel Predictors Of Prep Use Among Men Who Have Sex With Men In The United States, Kristina M. Rodriguez

Dissertations and Theses

Background: Men who have sex with men (MSM) remain the group most heavily affected by HIV in the United States (US), with MSM of color further disproportionately represented. In July 2012, the US Food and Drug Administration (FDA) approved the use of tenofovir disoproxil fumarate plus emtricitabine (TDF-FTC, Truvada) for use as pre-exposure prophylaxis (PrEP) in HIV-negative adults who are at high-risk of HIV infection. Despite its effectiveness, PrEP prescriptions are reaching only a small proportion of those who could benefit from the drug and prescription rates vary both by race and geographic region. The goal of this dissertation was …

Leveraging Technology To Blend Large-Scale Epidemiologic Surveillance With Social And Behavioral Science Methods: Successes, Challenges, And Lessons Learned Implementing The Unite Longitudinal Cohort Study Of Hiv Risk Factors Among Sexual Minority Men In The United States, H. Jonathon Rendina, Ali J. Talan, Nicola F. Tavella, Jonathan Lopez Matos, Ruben H. Jimenez, S. Scott Jones, Brian Salfas, Drew Westmoreland

Publications and Research

The use of digital technologies to conduct large-scale research with limited interaction (i.e., no in-person contact) and objective endpoints (i.e., biological testing) has significant potential for the field of epidemiology, but limited research to date has been published on the successes and challenges of such approaches. We analyzed data from a cohort study of sexual minority men across the United States, collected using digital strategies during a 10-month period from 2017 to 2018. Overall, 113,874 individuals were screened, of whom 26,000 were invited to the study, 10,691 joined the study, and 7,957 completed all enrollment steps, including return of a …

Burdern Of Chronic Health Conditions And Healthcare Utilization Among Mobile Populations In Sub-Saharan Africa, Elizabeth M. Ortiz

Dissertations and Theses

Background: Much of public health research in sub-Saharan Africa on mobile occupations, such as truck drivers and sex workers, has focused on HIV risk. However, evidence is emerging to suggest that the HIV epidemic among these groups is coupled with a high prevalence of chronic health conditions (CHC), specifically hypertension, diabetes, and obesity. For people living with HIV, increased risk of CHC may also be linked to HIV-related chronic inflammatory cascade. In Africa, there has been little research on CHC risk factors or patterns of healthcare utilization among mobile populations. Therefore, the objectives of this study are to examine the …

Comorbidities And Medication Adherence Among Older Individuals Living With Hiv In The United States, Amanda M. Kong

Dissertations and Theses

The number of people living with HIV (PLWH) ≥65 years old is increasing in the United States (US) as PLWH live longer. In 2015, there were nearly 1 million people living with diagnosed HIV in the US and under 10% were age ≥65. By 2035, the proportion of PLWH in this age group is projected to be 27%. Like the general population of elderly individuals, as they age, PLWH face age-related comorbidities, many of which require routine medical care and daily medications, in addition to daily antiretroviral therapy (ART) for treatment of HIV. Previous research has found that PLWH develop …

A Mendelian Randomization Study Of Coronary Artery Disease And Three Amino Acids: Alanine, Glycine, And Glutamine, Allan Uribe

Dissertations and Theses

Cardiovascular disease is the leading cause of death worldwide. Coronary Artery Disease (CAD) accounts for the majority of those deaths. Observational studies have identified risk factors that have been helpful in lowering the death rate, including hypertension, high cholesterol, diabetes, smoking, physical inactivity and poor diet. The effects of these risk factors on CAD remain unclear. To clarify the effect of three amino acids, alanine, glutamine, and glycine on CAD I applied a two sample Mendelian randomization analysis to extensively genotyped observational data. In a sample with up to 184,000 individuals and approximately 60,000 controls, SNPs that reached genome wide …

Interference And Control Of The Nosocomial Transmission Of Methicillin-Resistant Staphylococcus Aureus, Sen Pei, Flaviano Morone, Fredrik Liljeros, Hernan Makse, Jeffrey L. Shaman

Publications and Research

Methicillin-resistant Staphylococcus aureus (MRSA) is a continued threat to human health in both community and healthcare settings. In hospitals, control efforts would benefit from accurate estimation of asymptomatic colonization and infection importation rates from the community. However, developing such estimates remains challenging due to limited observation of colonization and complicated transmission dynamics within hospitals and the community. Here, we develop an inference framework that can estimate these key quantities by combining statistical filtering techniques, an agent-based model, and real-world patient-to-patient contact networks, and use this framework to infer nosocomial transmission and infection importation over an outbreak spanning 6 years in …

Factors Associated With Perceived Accuracy Of The Undetectable = Untransmittable Slogan Among Men Who Have Sex With Men: Implications For Messaging Scale-Up And Implementation, H Jonathon Rendina, J T. Parsons

Publications and Research

Introduction: Recent research has shown high efficacy of HIV treatment for reducing the risk of HIV transmission to sexual partners. As the efficacy of treatment as prevention (TasP) has proliferated, a new messaging campaign, Undetectable = Untransmittable, has been gaining popularity. The purpose of this paper was to assess factors associated with the perceived accuracy of this TasP messaging strategy among a large and diverse sample of gay, bisexual, and other men who have sex with men (GBMSM) in order to inform subsequent efforts at large-scale and implementation of the HIV prevention message.

Methods: We conducted a nationwide survey of …

The Association Between A Body Shape Index And Cardiovascular Risk In Overweight And Obese Children And Adolescents, Chiara Mameli, Nir Y. Krakauer, Jesse C. Karakauer, Alessandra Bosetti, Chiara Matilde Ferrari, Norma Moiana, Laura Schneider, Barbara Borsani, Teresa Genoni, Gianvincenzo Zuccotti

Publications and Research

A Body Shape Index (ABSI) and normalized hip circumference (Hip Index, HI) have been recently shown to be strong risk factors for mortality and for cardiovascular disease in adults. We conducted an observational cross-sectional study to evaluate the relationship between ABSI, HI and cardiometabolic risk factors and obesity-related comorbidities in overweight and obese children and adolescents aged 2±18 years. We performed multivariate linear and logistic regression analyses with BMI, ABSI, and HI age and sex normalized z scores as predictors to examine the association with cardiometabolic risk markers (systolic and diastolic blood pressure, fasting glucose and insulin, total cholesterol and …

Towards An Integrated Primary And Secondary Hiv Prevention Continuum For The United States: A Cyclical Process Model, Tim Horn, Jennifer Sherwood, Robert H. Remien, Denis Nash, Judith D. Auerbach

Publications and Research

Introduction: Every new HIV infection is preventable and every HIV-related death is avoidable. As many jurisdictions around the world endeavour to end HIV as an epidemic, missed HIV prevention and treatment opportunities must be regarded as public health emergencies, and efforts to quickly fill gaps in service provision for all people living with and vulnerable to HIV infection must be prioritized.

Discussion: We present a novel, comprehensive, primary and secondary HIV prevention continuum model for the United States as a conceptual framework to identify key steps in reducing HIV incidence and improving health outcomes among those vulnerable to, as well …

Ethnicity Matters: Implications For Understanding And Acting Upon Disparities In Health Affecting Black Men In The United States, Helen V. S. Cole

Dissertations, Theses, and Capstone Projects

Compared to non-Hispanic whites, non-Hispanic blacks have higher rates of mortality from heart disease, cancer, cardiovascular disease, and HIV/AIDS. Black men have a life expectancy approximately 4.7 years than the life expectancy of non-Hispanic white men, due in part to higher prevalence of chronic disease among black men. Many factors are hypothesized to contribute to disparities in health between races, including differences in socioeconomic status; culturally-linked behaviors such as diet, substance use, and physical activity; access to quality healthcare and other resources; and experiences of racism, both institutional and interpersonal. However, in public health research, race is usually treated as …

Prevalence Of Chronic Health Conditions Among Latinos In The United States Between 1990 And 2011, Amanda Mia Marín-Chollom

Center for Latin American, Caribbean, and Latino Studies

Introduction: This study examines the prevalence of five major chronic health conditions – heart disease, stroke, cancer, arthritis, and diabetes – among adults 18 years of age and older in the United States between 1999 and 2011.

Methods: The data used in this report come from the Center for Disease Control and Prevention’s (CDC) National Center for Health Statistics, Health Data Interactive tables. Patterns were examined by age structure among the four largest race/ethnic groups in the U.S., and among the two largest Latino subgroups in the U.S. (Mexicans and Puerto Ricans)

Results: Latinos had higher rates of diabetes than …

Factors Associated With Initiation Of Antiretroviral Therapy In The Advanced Stages Of Hiv Infection In Six Ethiopian Hiv Clinics, 2012 To 2013, Denis Nash, Olga Tymejczyk, Tsigereda Gadisa, Sarah Gorrell Kulkarni, Susie Hoffman, Muluneh Yigzaw, Batya Elul, Robert H. Remien, Maria Lahuerta, Shalo Daba, Wafaa El Sadr, Zenebe Melaku

Publications and Research

Introduction: Most HIV-positive persons in sub-Saharan Africa initiate antiretroviral therapy (ART) with advanced infection (late ART initiation). Intervening on the drivers of late ART initiation is a critical step towards achieving the full potential of HIV treatment scale-up. This study aimed to identify modifiable factors associated with late ART initiation in Ethiopia.

Methods: From 2012 to 2013, Ethiopian adults (n=1180) were interviewed within two weeks of ART initiation. Interview data were merged with HIV care histories to assess correlates of late ART initiation (CD4+ count <150 cells/mL or World Health Organization Stage IV).

Results: The median CD4 count at enrolment in HIV care was 263 cells/mL (interquartile range …

Parasitic Diseases Of The Central Nervous System: Lessons For Clinicians And Policy Makers, Arturo Carpio, Matthew L. Romo, R.M.E. Parkhouse, Brooke Short, Tarun Dua

Publications and Research

Parasitic diseases of the central nervous system are associated with high mortality and morbidity, especially in resource-limited settings. The burden of these diseases is amplified as survivors are often left with neurologic sequelae affecting mobility, sensory organs, and cognitive functions, as well as seizures/epilepsy. These diseases inflict suffering by causing lifelong disabilities, reducing economic productivity, and causing social stigma. The complexity of parasitic life cycles and geographic specificities, as well as overlapping clinical manifestations in the host reflecting the diverse pathogenesis of parasites, can present diagnostic challenges. We herein provide an overview of these parasitic diseases and summarize clinical aspects, …

Multilevel Analysis Of Individual, Neighborhood, And Health Care Facility Characteristics Associated With Achievement And Maintenance Of Hiv Viral Suppression Among Persons Newly Diagnosed With Hiv In New York City, Ellen W. Wiewel

Dissertations, Theses, and Capstone Projects

Objective

To investigate the effect of individual, health care facility, and neighborhood characteristics on achievement and maintenance of HIV viral suppression, among New York City residents aged 13 years and older diagnosed with HIV between 2006 and 2012.

Methods

I used individual-level data from the New York City HIV surveillance registry and Case Surveillance-Based Sampling, facility-level data from the surveillance registry, and neighborhood-level data from the U.S. Census and American Community Survey. The outcomes of interest were first viral suppression after diagnosis (Aims 1 and 3; ≤400 copies/mL) and virologic failure after first suppression among persons who achieved suppression (Aim …