Epidemiology Commons^™

Decoding Implant-Related Sickness: Unraveling The Complexities Of Breast Implant Illness, Madison M. Stewart

Senior Theses

This thesis investigates the phenomenon of breast implant illness (BII), examining its potential correlation with individual factors such as obesity and poor lifestyle habits. BII, characterized by nonspecific symptoms, is often self-diagnosed by patients influenced by social media and internet sources, leading to requests for implant removal. Conducting a comprehensive meta-analysis, the study scrutinizes existing literature to evaluate the association between BII, obesity, and lifestyle choices. Employing inclusion criteria, peer-reviewed publications are analyzed through systematic review methodology to offer insights into the interplay between BII and adiposity, exploring inflammatory mechanisms and patient behaviors like exercise and smoking. The research aims …

A Cross-Sectional Analysis Of Adverse Childhood Experience Exposure On Cancer Diagnosis Utilizing The 2022 Behavioral Risk Factor Surveillance Survey Data, Emma Zipperer

Capstone Experience

Objective: To determine the association between Adverse Childhood Experiences (ACEs) and cancer diagnosis based on ACE exposure levels.

Methods: We utilized data collected in the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey. The study population (n=54,148) was restricted to states that reported on the optional model of experiencing ACEs and those who responded about cancer diagnosis. A univariate analysis, bivariate analysis and a multivariate logistic regression were performed. Odds of cancer diagnosis among those with differing ACE exposure levels were calculated.

Results: High ACE exposure had 20% higher odds of cancer diagnosis when compared to low ACE exposure. White, …

Exploration Of The Implementation Of An Integrated Electronic Laboratory Information Management System On Quality Diagnostics Service Indicators At A County Level Public Hospital In Western Kenya., Kelly Allen

Capstone Collection

Underinvestment in pathology and laboratory capacity caused by low visibility in research and in prioritization by public health leaders results in limited effective healthcare coverage and an estimated 1.1 million premature deaths annually in Low-and-Middle-Income Countries. Kenya’s public health laboratories provide a median 41% of the Essential Diagnostic List to their patients and in Kisumu County, as much as 44.2% of the population has little to no access to essential diagnostics. The government of Kisumu implemented the county Health Laboratory Strategic Plan 2018-2022 to address this public health challenge. Little information exists on the effectiveness of these initiatives and the …

Incidence And Determinants Of Hypertensive Disorders Of Pregnancy In The Us: Hospitalization Discharge Rate For Preeclampsia, Eclampsia, And Gestational Hypertensions, 2016-2018., Kahir S. Jawad

Electronic Theses and Dissertations

Background: Hypertension remains one of the most prevalent medical issues in pregnancy. It contributes considerably to maternal and fetal morbidity and mortality, making it one of the most significant public health problems. Although various epidemiological studies have been conducted over the past decades to assess the disease incidence and key risk factors associated with hypertensive disorders of pregnancy, current incidence rates and trends are lacking. This is a novel and significant study because there are no current population-based incidence estimates of hypertensive disorders of pregnancy and their subtypes and very few studies with the power to explore a wide range …

Sociodemographic Factors And The Risk Of Paediatric Out-Of-Hospital Cardiac Arrest, Samina Idrees

Electronic Thesis and Dissertation Repository

Paediatric out-of-hospital cardiac arrest (POHCA) is associated with poor survival and severe neurological sequelae. This thesis aims to explore the relationship between sociodemographic factors and POHCA. The findings from our systematic review indicate that there are racial disparities in POHCA risk and in the provision of bystander cardiopulmonary resuscitation. There was little evidence of sociodemographic disparities in bystander defibrillation, survival and neurological outcome, particularly across adjusted analyses. The findings from our case-control study in Ontario, Canada, indicate that children living in marginalized areas have an elevated risk of experiencing POHCA. We also found that children living in northern urban or …

Epidemiology Of Island And Mainland Populations: How Does Culture Influence Health Risk Factors Of Non-Communicable, Chronic, And Metabolic Diseases?, Jake Thomas D. Palisoc

Honors Projects

Non-communicable diseases (NCDs), including chronic and metabolic diseases, are responsible for 74% of global mortality and are strongly influenced by health risk factors. Geographical differences in NCDs have been identified in several countries but have not been completely explained through cultural factors, specifically island and mainland cultures. This study aimed to develop an epidemiological framework for determining diseases with the highest mortality for further investigation regarding different health risk factors rooted in a specific population’s cultural foundations. Preliminary findings indicated diabetes type II (D2) and CKD caused by hypertension and D2 to have the highest risk factor and mortality percentage …

Emerging Tick-Borne Diseases In Northeast Tennessee, Jacob Schultz

Electronic Theses and Dissertations

Tick populations have been immigrating into northeast Tennessee from east Tennessee, Kentucky, Virginia, and North Carolina. Counties in states bordering northeast Tennessee harbor tick species associated with human illness. Human diseases transmitted by ticks include ehrlichiosis, spotted fever rickettsial group diseases, tularemia, anaplasmosis, babesiosis, Lyme disease, alpha-gal syndrome, Heartland virus, Powassan virus, and southern tick-associated rash illness (STARI). These diseases cause morbidity and mortality in human populations and may pose a high risk to individuals, wildlife, and livestock. The Cherokee National Forest covering the east Tennessee border provides a permissible environment for ticks to immigrate and thrive. Residents of northeast …

Assessing The Impact Of Ebola Virus Inoculum Size On Likelihood Of Infection, Joseph Lukowski

Capstone Experience

Background: Indirect transmission of Ebola virus disease (EVD) is not uncommon but is poorly understood. Improving the understanding of the potential risk of EVD transmission from fomites should result in new or updated prevention or control measures for suspected or confirmed EVD cases or outbreaks.

Objective: This study aims to compile and understand pertinent data from peer-reviewed literature, establish the dose-response relationship between inoculum doses introduced to mucous membranes, and finally estimate the risk of EVD transmission from fomites.

Methods: A literature search was conducted through PubMed to obtain relevant data. This study employed this data to perform Poisson regression …

Promoting Healthier Treatment Outcomes In Obese Cancer Patients Taking High Dose Methotrexate, Carly Dell'ova

Walden Dissertations and Doctoral Studies

Cancer and obesity rates continue to rise, creating enormous public heath burdens to the individual and at the national and global levels, reducing quality of life, and increasing spending. Moreover, the relationships between cancer and obesity are not well understood. A commonly used chemotherapy for several types of cancer is high dose methotrexate (HDMTX). Along with chemotherapy, especially at high doses, comes toxicity to specific organs and the entire body. However, limited research has been conducted on obese cancer patients as they are often excluded from clinical studies. Practitioners need to better understand how to dose these patients to provide …

Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne

Walden Dissertations and Doctoral Studies

Less than half of U. S. students entering college have had a human papillomavirus (HPV) vaccination, placing them at risk for HPV-related cancers. This study’s purpose was to identify predictors of HPV vaccination initiation in college students. Andersen’s behavioral model of health services use was used to examine the differences in predisposing, enabling, and need factors in U.S. college students ages 18–26 years who received an initial HPV vaccination in college compared to those who never received an HPV vaccination. The study was a quantitative, cross-sectional survey design using multivariable logistic regression for data analyses. Data were collected through an …

Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne

Walden Dissertations and Doctoral Studies

Less than half of U. S. students entering college have had a human papillomavirus (HPV) vaccination, placing them at risk for HPV-related cancers. This study’s purpose was to identify predictors of HPV vaccination initiation in college students. Andersen’s behavioral model of health services use was used to examine the differences in predisposing, enabling, and need factors in U.S. college students ages 18–26 years who received an initial HPV vaccination in college compared to those who never received an HPV vaccination. The study was a quantitative, cross-sectional survey design using multivariable logistic regression for data analyses. Data were collected through an …

The Effect Of An Educational Handout On Knowledge, Awareness And Attitudes Of Pre-Exposure Prophylaxis (Prep) Among Participants At A Needle And Syringe Exchange Site, Mckenzie Buckel

DNP Projects

Background: In 2018, the total number of HIV cases in the United States was 1.2 million. Almost 186,500 of these cases were attributed to intravenous drug use. With the adherence to pre-exposure prophylaxis (PrEP) there is approximately a 49% decrease in the rates of HIV among people who inject drugs and the most significant barrier to PrEP among this population is a lack of awareness and knowledge.

Objective: The purpose of this study was to determine participants’ of a needle and syringe exchange site knowledge, awareness and attitudes of PrEP after reviewing an educational handout about PrEP.

Methods: A quasi …

Uncovering The Role Of Fat-Infiltrated Axillary Lymph Nodes In Obesity-Related Diseases With Statistical And Machine Learning Analyses, Qingyuan Song

Dartmouth College Ph.D Dissertations

The link between obesity and pathogenesis is a complex and multifaceted area of research that is yet to be fully understood. Ample evidence exists to demonstrate the direct relationship between excessive internal fat and various health conditions such as cancer, and metabolic and cardiovascular diseases. The infiltration of ectopic fat into axillary lymph nodes, observable on breast cancer screening images, has been shown to be correlated with body mass index (BMI) in women undergoing screening. This study aimed to explore the relationship between fat-infiltrated axillary lymph nodes (FIN) and obesity-related diseases, with the goal of evaluating the clinical value of …

Prospective Investigation Of Insomnia Symptoms And Sleep Duration As Risk Factors For Stroke Incidence And All-Cause Mortality In U.S Adult, Wendemi Sawadogo

Theses and Dissertations

Background and Objectives: Stroke is the second leading cause of death in the world. In the United States, on average, someone has a stroke every 40 seconds and someone dies as a result of stroke every 3.5 minutes. Identifying modifiable risk factors of stroke is therefore a public health priority. The purpose of this study was to investigate the extent to which insomnia symptoms and sleep duration contribute to stroke incidence, all-cause mortality, and explore potential causal pathways.

Methods: The Health and Retirement Study (HRS) and the REasons for Geographic And Racial Differences in Stroke (REGARDS) study were …

Severe Lower Extremity Trauma In Ontario: A Linked Population-Based Analysis, Stephanie M. Kim

Electronic Thesis and Dissertation Repository

Open tibia fractures (OTF) are a management challenge. Admission to a trauma center (TC) and a coordinated approach to bony fixation and soft-tissue reconstruction (STR) have been shown to improve outcomes. The objective of this study was to describe patients who had OTF in Ontario and analyze their outcomes. Linked population data pertaining to patients who had OTF between the years 2009-2020 were examined. Demographic information, admission location, and management course were collected. 4240 patients were found. The mean age was 47, and majority were males. Patients admitted to TC had greater proportion of having Injury Severity Score >15, and …

Multimorbidity And Cognition Among Canadian Older Adults: A Three-Decade Perspective, Juan Camilo Vargas Gonzalez

Electronic Thesis and Dissertation Repository

Background: Scarce information exists about whether the relationship between multimorbidity and cognitive decline has changed over the past decades.

Objectives: 1) To summarize knowledge about the association of multimorbidity and cognitive decline by performing a systematic review. 2) To estimate the association between multimorbidity in two cohorts selected three decades apart. 3)To identify which multimorbidity combinations have the strongest associations with cognitive decline 4) To identify protective factors that reduce the risk of cognitive decline in the presence of multimorbidity.

Methods: We performed a systematic review following the PRISMA statement. We then addressed objectives 2-4 by analyzing data from two …

Effectiveness Of Machine Learning Classifiers For Cataract Screening, Ronald Cheung

Electronic Thesis and Dissertation Repository

Cataract is the leading cause of blindness and vision loss globally. The implementation of artificial intelligence (AI) in the healthcare industry has been on the rise in the past few decades and machine learning (ML) classifiers have shown to be able to diagnose patients with cataracts. A systematic review and meta-analysis were conducted to assess the diagnostic accuracy of these ML classifiers for cataracts currently published in the literature. Retrieved from nine articles, the pooled sensitivity was 94.8% and the specificity was 96.0% for adult cataracts. Additionally, an economic analysis was conducted to explore the cost-effectiveness of implementing ML to …

How Environmental Change Will Impact Mosquito-Borne Diseases, Arsal Khan

Master's Projects and Capstones

Mosquitos, the most lethal species throughout human history, are the most prevalent source of vector-borne diseases and therefore a major global health burden. Mosquito-borne disease incidence is expected to shift with environmental change. These changes can be predicted using species distribution models. With the wide variety of methods used for models, consensus for improving accuracy and comparability is needed. A comparative analysis of three recent modeling approaches revealed that integrating modeling techniques compensates for trade-offs associated with a singular approach. An area that represents a critical gap in our ability to predict mosquito behavior in response to changing climate factors, …

Evaluation Of Awareness, Knowledge, And Preventive Intervention Of Nonalcoholic Fatty Liver Disease Among Chinese Young Adults, Yi Du

Theses & Dissertations

The prevalence of nonalcoholic fatty liver disease (NAFLD) among Chinese young adults (CYA) aged 18-25 years ranges from 4.7% to 15.1% and has kept increasing in recent years. Previous studies reported limited awareness and knowledge of NALFD among middle-aged and older Chinese populations, however, they have not investigated awareness in CYA, for which there is no well-validated questionnaire. There is currently no efficacious educational intervention on NAFLD for CYA.

The objectives were 1) to develop and validate a questionnaire which can be used to assess the awareness and knowledge of NAFLD among CYA; 2) to assess the awareness and knowledge …

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 …

Incidence Of Cancer And Stage At Diagnosis Among People With Recent-Onset Psychotic Disorders, Jared C. Wootten

Electronic Thesis and Dissertation Repository

Evidence on cancer incidence in people with psychotic disorders, compared to the general population, is equivocal, although those with psychotic disorders so have more advanced stage of cancer at the time of diagnosis. The objective of this thesis was to compare cancer incidence and stage at diagnosis for people with psychotic disorders, relative to the general population. Our systematic review did not observe a significant difference in overall cancer incidence among people diagnosed with psychotic disorders (RR = 1.08, 95% CI: 1.00 to 1.16), however people with psychotic disorders were more likely to be present with advanced stage cancer at …

Fall Risk-Increasing Drugs And Gait Performance In Community-Dwelling Older Adults: Results From The Gait And Brain Study, Abdelhady Osman

Electronic Thesis and Dissertation Repository

Medication use and gait impairment are two of the most important risk factors for falls. Several drug classes have been classified as fall risk-increasing drugs (FRIDs). Gait is an important marker of overall health and independence in older adults. The overall aim of this thesis was to examine the relationship between FRIDs and gait performance in older adults through two studies. Firstly, our systematic review of twenty studies on the association between FRIDs and gait performance found that the use of drugs with sedative properties is associated with reduced gait speed. Secondly, we conducted a cross-sectional analysis of data from …

Interplay Between Shift Work, Psychological Distress, Sleep Quality, And Cognitive Performance, Rea Therese Alonzo

Electronic Thesis and Dissertation Repository

Shift work schedules are designed to maintain a continuous operation of goods and services. However, engaging in shift work may impact cognitive functioning. This thesis assessed the relationship between shift work and cognitive performance. Using cross-sectional data from the Canadian Longitudinal Study on Aging, multiple linear regression models were used to investigate the association between shift work and cognitive performance, as well as the moderating effects of psychological distress and sleep quality. Differences by sex and retirement status were also investigated. Shift work was significantly associated with poor performance for executive functioning but not for declarative memory. Poorer cognitive performance …

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) …

Fire Service Covid-19 Infection Prevention And Control Policy Comparison, Saaddedine Dichari

Theses & Dissertations

To date, there have been over 2.7 million deaths and more than 126 million cases attributed to the COVID-19 pandemic (JHU, 2021). This pandemic has affected nearly every aspect of daily life. Among those impacted are U.S. firefighters, as they provide many services beyond simply extinguishing structure fires and are frequently dual certified as emergency medical technicians. Many of the victims of this pandemic have relied on first responders to provide them with emergency medical care and hospital transport. When caring for these infected patients, firefighters have an increased risk of exposure and must be provided with adequate …

Clinical Consequences And Determinants Of False Positive Blood Cultures In Adult Hospitalized Patients, Sidra Liaquat

Theses & Dissertations

Blood cultures are the gold standard for detecting blood stream infections. However, in the US, 0.6-6% of all blood cultures get contaminated leading to adverse clinical outcomes such as unnecessarily prolonged hospital stay and antibiotic therapy. Using electronic medical records, we explored the clinical outcomes and patient-specific risk factors of contaminated blood cultures in an era where rapid blood culture testing was being utilized to provide blood culture results within hours. Rapid blood culture test results can help clinicians in early and more effective management of patients with contaminated blood cultures, thus improving clinical outcomes. We also studied the impact …

Association Between Air Pollution And Incidence Of Dementia: A Systematic Review And Meta-Analysis Of Cohort Studies, Ehsan Abolhasani

Electronic Thesis and Dissertation Repository

Objective. To estimate the risk of dementia in association with exposure to air pollutants.

Methods. Six databases were searched. Cohort studies that reported the hazard ratio (HR) of dementia in association with exposure to air pollutants in adults > 40y were included. For all meta-analyses, the random-effects model was used.

Results. A total of 16 and 13 studies were included in the systematic review and the meta-analysis, respectively. Risk of dementia increased by 4% per 1μg/m³ increase in fine particulate matter level (HR, 1.04; 95%CI, [1.02, 1.06]), which was statistically significant. The risk of dementia increased by 3% per 10μg/m …

Applied Methodologies Demonstrated Through Three Independent Studies For Assessing The Effects Of Socioeconomic, Environmental Chemical Exposure, And Therapeutic Factors On Oncological Diseases And Covid-19, Bayarmagnai Maggie Munkhjargal

Legacy Theses & Dissertations (2009 - 2024)

When trying to understand risk factors for a disease, even before we know the causal agents, it is necessary to create a surveillance data set that answers the questions of who, when, and where, and includes any potential covariates which may either promote or prevent the disease. There are a wide variety of surveillance data. For example, hospital discharge data, such as the New York Statewide Planning and Research Cooperative System (SPARCS) data, encompass all hospitalized cases in the state, while clinical datasets cover a specially constructed population in pursuit of research of a certain disease type. Analysis of surveillance …

Mood And Anxiety Disorders, Measurement, And Migrant Groups In Ontario, Jordan Edwards

Electronic Thesis and Dissertation Repository

Our objectives were to: (1) evaluate the current literature on the epidemiology of mood or anxiety disorders among migrant groups; (2) assess how current tools for measuring mood or anxiety disorders at the population level influence our understanding of the epidemiology by a) analyzing the concordance between two commonly used population measures, and b) using a Bayesian analysis to create a combined estimate using both measures; (3) estimate the prevalence and effects of potential risk factors on the prevalence of mood or anxiety disorders among first-generation migrant groups compared to the general population in Ontario. We conducted a systematic review …

Structural Magnetic Resonance Imaging As A Diagnostic Biomarker Of Hiv-Associated Neurocognitive Disorders (Hand), Mikki Schantell

Capstone Experience

Objective: The goal of this study was to do an exploratory analysis to determine if gray matter brain volumes and cortical thickness measures obtained from structural magnetic resonance imaging (sMRI) can discriminate people with HIV-associated neurocognitive disorders (HAND), neurocognitively unimpaired people with HIV (NU PWH), and HIV-negative controls (HIV- controls) using linear discriminant analyses.

Methods: A total of 231 participants, including 110 PWH and 121 HIV- controls, completed a neuropsychological (NP) battery and an sMRI protocol. The bilateral gray matter volumes and cortical thickness brain regions were analyzed using 18 linear discriminant models to assess the discriminability of gray matter …