Epidemiology Commons^™

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 …

Neighborhood Deprivation, Food Insecurity And Gestational Weight Gain, Sabrina Luke

USF Tampa Graduate Theses and Dissertations

Gestational weight gain outside the recommended ranges puts women at risk for pregnancy complications and adverse birth outcomes. Food insecurity and environmental factors including neighborhood deprivation may influence gestational weight gain. This research 1) examines the impact of neighborhood deprivation on gestational weight gain, 2) identifies if the association varies by selected maternal characteristics, 3) examines the relationship between food insecurity and gestational weight gain, 4) determines if stress mediates the relationship between food insecurity and gestational weight gain, and 5) examines whether selected maternal characteristics mediate this relationship. The research was conducted through the analysis of the Pregnancy Risk …

Rhabdomyosarcoma Incidence And Survival In Whites, Blacks, And Hispanics From 1973-2013: Analysis From The Surveillance, Epidemiology, And End Results Program, Heather Tinsley

USF Tampa Graduate Theses and Dissertations

Purpose

Our objectives were to 1) determine the difference in Rhabdomyosarcoma (RMS) incidence and survival between different race/ethnicity groups, and 2) evaluate the difference in survival of RMS between children and adults of these race/ethnicity groups, using the Surveillance, Epidemiology, and End Results Program (SEER) database between 1973-2013.

Patients and Methods

We analyzed racial characteristic and incidence data from 4,280 patients diagnosed with RMS, between 1973-2013, that were reported to the SEER database. Survival and hazard analyses were conducted on 4,268 patients with known follow-up data, with end point being death from any cause.

Results

Over the 40-year study period …

Association Between Folate Levels And Preterm Birth In Tampa, Florida, Carolyn Heeraman

USF Tampa Graduate Theses and Dissertations

Background: Preterm birth is one of the leading causes of perinatal mortality and morbidity and poses extensive economic liability. The rate of preterm births globally is approximately 11.1%, and in the US, the preterm birth rate has been estimated to be 12-13%. Folate and B₁₂ requirements increase during pregnancy as a result of increased cell division to accommodate maternal and fetal growth; inadequate levels can result in placental abnormalities and thus present implications for preterm birth.

Objective: To investigate the association between red blood cell (RBC) folate and B₁₂ concentrations with the risk of preterm birth.

Methods: Study …

Hiv/Stis And Intimate Partner Violence: Results From The Togo 2013-2014 Demographic And Health Surveys, Anthony H. Nguyen

USF Tampa Graduate Theses and Dissertations

Background: Among clinic based studies, intimate partner violence (IPV) has been shown to contribute to HIV/AIDS among young girls and women. Results from studies among the general population have been less consistent. This study evaluated the associations between HIV infection, any sexually transmitted infections, and IPV in a population based sample of Togolese women.

Methods: Data from the Togo 2013-2014 Demographic and Health Surveys were utilized for these analyses. Women aged 15-49 who were currently married, had HIV test results and answered the Domestic Violence Module were analyzed (n = 2386). Generalized linear mixed-models adjusting for sociodemographic variables, risk behaviors, …

Racial And Ethnic Differences In Low-Risk Cesarean Deliveries In Florida, Yuri Combo Vanda Sebastiao

USF Tampa Graduate Theses and Dissertations

Background and Significance: Cesarean delivery rates increased by more than 50% between 1996 and 2011 in the United States. The large increase in rates for the procedure was generally not associated with significant improvements in obstetric outcomes, raising concern about quality and prompting recommendations for prevention. Primary cesareans provide the best opportunity to reduce overall cesarean rates, and the group of first-time mothers considered low-risk for cesarean (known as nulliparous, term, singleton, vertex, NTSV) constitutes the focus of prevention efforts. Studies increasingly report racial and ethnic differences in NTSV cesareans, which remain after controlling for health factors. However, the reasons …

The Effects Of Personal And Family History Of Cancer On The Development Of Dementia In Japanese Americans: The Kame Project, Adam Lee Slotnick

USF Tampa Graduate Theses and Dissertations

An increasing number of studies have shown an inverse association between a personal history of cancer (PHC) and dementia/Alzheimer’s disease (AD), both in those using dementia/AD as the outcome or cancer as the outcome. This is the first study to examine this potential association in Japanese Americans; and to examine family history of cancer and its association with incident dementia. Also, the association between these two diseases in the parents of participants were analyzed.

The Kame Project, conducted from 1992 through 2001 in King County, Washington was a population-based, prospective cohort study of older Japanese Americans. Conversion to incident dementia …

Sleep Duration Patterns From Adolescence To Young Adulthood And Their Impact On Asthma And Inflammation, Chighaf Bakour

USF Tampa Graduate Theses and Dissertations

This dissertation includes three studies that examined the impact of inadequate sleep duration in adolescents and young adults on asthma and systemic inflammation. We used data from the Florida Youth Risk Behavior Survey (YRBS), years 2009-2013, and from the National Longitudinal Study of Adolescent to Adult Health (Add health), which was conducted between 1994 and 2008.

The first study used data from 16,738 high school students participating in the Florida YRBS. We examined the cross-sectional association between sleep duration and asthma, and the interactive effects of sleep duration and BMI. We found that short and long sleep durations were associated …

Association Of Known And Unknown Oncoviruses With External Genital Lesion (Egl) Manifestations In A Multinational Cohort Of Men, Shams Ur Rahman

USF Tampa Graduate Theses and Dissertations

Human papillomaviruses (HPV) are double-stranded, DNA, epitheliotropic viruses that infect skin and mucosal membranes. Over 200 types of HPV have been identified and classified into alpha (α), beta (β), gamma (γ), mu (µ), and nu (ν) genera. HPV in the genus α mainly infect mucosal membranes, cause the majority of the ano-genital cancers, and are widely studied. However, epidemiology of HPV in the other genera, which mainly infect skin, is poorly understood. Few studies have reported the seroprevalence of cutaneous HPV among healthy individuals, and to date, no study has prospectively examined the association between cutaneous HPV seropositivity and development …

Statistical Analysis And Modeling Health Data: A Longitudinal Study, Bhikhari Prasad Tharu

USF Tampa Graduate Theses and Dissertations

Lung cancer has been considered one of the leading causes of deaths while cancer re- mains the second most common cause of deaths in the USA. Understanding the behavior of a disease over time could yield important information to make decisions about the disease. Statistical models could provide crucial clues and help to make a decision about the dis- ease, budget allocation, evaluation, and implement prevention. Longitudinal trend analysis of the diseases helps to understand long term effects and nature. Cholesterol level is one of the most contributing risk factors for Coronary Heart Disease. Studying cholesterol statistically helps to know …

Investigating Pakistan’S Contraception Rate Plateau: A Multilevel Analysis To Understand The Association Between Community Contextual Factors And Modern Contraception Use, Mahmooda Khaliq Pasha

USF Tampa Graduate Theses and Dissertations

South Asia has the highest absolute number of women with an unmet need for contraception in the world. The total number of women with unmet need is 142 million. Of this, Asia accounts for 84 million followed by Sub-Saharan Africa at 32 million. Within South Asia, some countries have seen unmet need decrease and the contraception rate increase; however, Pakistan remains the exception to the rule. Pakistan has a low rate of contraception use, high rate of contraception discontinuation, high unmet need and high rate of unwanted fertility.

A number of theories have hypothesized that community-level factors influence a couple’s …

Quantifying The Association Between Active Tuberculosis Incidence And Migrant Farm Worker Populations Among Florida Counties, 2009-2013: An Ecological Study, Ryan Nicolas Ortega

USF Tampa Graduate Theses and Dissertations

Nearly 20 studies conducted in the last 40 years indicate that tuberculosis (TB) represents a major health concern among migrant farm worker (MFW) populations, but their role in the transmission of TB within the broader community is poorly understood. To this end an ecological study was undertaken which examined 67 Florida counties between years 2009 through 2013. Its aims were as follows: (1) to describe the demographic, geographic, and temporal distribution of the incidence of active TB, (2) to examine the effect of agriculturally relevant seasonal periods on the incidence of active TB, and (3) to quantify the strength and …

An Examination Of The Distribution Of Diabetes Mellitus Among Tb Patients With Pulmonary Tuberculosis And Drug Resistant Tuberculosis In The State Of Florida, Usa., Mandzisi Mbongeni Mkhontfo

USF Tampa Graduate Theses and Dissertations

Background: Pulmonary Tuberculosis (PTB) is considered a disease of the past but it remains a major cause of mortality among immune compromised patients and continues to be a significant threat to public health globally. Notably, the prevalence of diabetes mellitus (DM) has increased over the years. The biological link of TB and DM has been reported in numerous literature with DM attributed to three folds increase in the risk of TB and linked to Drug Resistant TB, especially amongst aged diabetic patients. The aim of the study was to examine the distribution of DM among TB patients and explore …

Incidence, Persistence, And Recurrence Of Anogenital Α- Mucosal Hpv Infections (Hpv 6, 11, 16, 18, 31, 33, 45, 52 And 58), Shitaldas J. Pamnani

USF Tampa Graduate Theses and Dissertations

Objectives: The aims of this study were to: 1) Assess whether naturally induced anti-HPV antibodies are associated with subsequent acquisition of genital HPV 6, 11, 16, and 18 infections in men, 2) assess the recurrence (redetection) of genital HPV infections of the 9-valent vaccine HPV types and investigate factors associated with recurrent infections among men, and 3) assess the risk of type-specific sequential acquisition of anal HPV infection following a genital HPV infection of the 9-valent vaccine HPV types among men who have sex with women (MSW).

Methods: 4,123 healthy men were followed every six months (median follow-up time 4.1 …

Factors Associated With Sexually Transmitted Infections (Stis) And Multiple Sti Co-Infections: Results From The Evri Hiv Prevention Preparedness Trial, Ubin Pokharel

USF Tampa Graduate Theses and Dissertations

Objective: The objective of this study was to describe the prevalence of sexually transmitted co-infections and assess factors associated with a single infection and co-infections.

Methods: A total of 388 women were included in this study. At enrollment of the EVRI trial women were tested for five STIs: Human papilloma virus (HPV), Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex virus-2 (HSV-2) and Treponema pallidum. Prevalence of STI infections and proportion of women with different combinations of co-infections were calculated. Factors associated with single infection and STI co-infection were assessed using a polytomous logistic regression model and odds ratio …

Effect Of Timely Treatment On Malaria Gametocytemia In Esmeraldas, Ecuador, Miguel Reina-Ortiz

USF Tampa Graduate Theses and Dissertations

Malaria is a disease that causes great burden in public health worldwide. It was estimated that in 2011 there were 3.3 billion people at risk of acquiring malaria. According to data from the Ministry of Public Health of Ecuador, malaria incidence has shown a 99.9% steady decrease since year 2000. This study evaluated the effect of timely treatment on circulating gametocyte and malaria incidence rates. All cases reported in the province of Esmeraldas, Ecuador from July 2012 to March 2015 and to the national headquarters between February 2012 and December 2014 were studied. The effect of early treatment on: 1) …

Basic Epidemiology, Center For Leadership In Public Health Practice

Preparedness and Emergency Response Learning Center

Basic Epidemiology, a training course from the USF Center for Leadership in Public Health Practice, develops the awareness and knowledge of public health workers who may be deployed on Field Epidemiology strike teams. It is designed to help them assist local, regional, state, and national epidemiology staff in disease investigations during surge capacity. Basic Epidemiology is a required prerequisite for the IFIRST and IFIRST-2 programs.

Assessment Of The Impact Of Attention Deficit Hyperactivity Disorder On Type 1 Diabetes, Kellee Miller

USF Tampa Graduate Theses and Dissertations

Individual day-to-day management and effective control of type 1 diabetes (T1D) is ultimately driven by decisions made by the individual. Individuals with attention deficit hyperactivity disorder (ADHD) have a higher tendency to be inattentive, impulsive, and hyperactive. Attention deficits and impulsivity among adolescents and adults with T1D could result in poor diabetes management through infrequent self-monitoring of blood glucose and inadequate insulin dosing – key components of achieving optimal glycemic control.

This study included 7,380 adolescents and young adults, ages 13-25 years, participating in the T1D Exchange clinic registry (median age 17.4 years, duration 7.7 yrs, 50% female, 81% white). …

Statistical Analysis And Modeling Of Pm2.5 Speciation Metals And Their Mixtures, Boubakari Ibrahimou

USF Tampa Graduate Theses and Dissertations

Exposure to fine particulate matter (PM_2.5) in the ambient air is associated with various health effects. There is increasing evidence which implicates the central role played by specific chemical components such as heavy metals of PM_2.5. Given the fact that humans are exposed to complex mixtures of environmental pollutants such as PM_2.5, research efforts are intensifying to study the mixtures composition and the emission sources of ambient PM, and the exposure-related health effects. Factor analysis as well source apportionment models are statistical tools potentially useful for characterizing mixtures in PM_2.5. However, classic …

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 …

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 …

Water And Health In The Nandamojo Watershed Of Costa Rica: Community Perceptions Towards Water, Sanitation, And The Environment, James Mcknight

USF Tampa Graduate Theses and Dissertations

Understanding the relationships between human health, water, sanitation, and environmental health is a requirement to understanding the challenges that face researchers when it comes to addressing global health relating to water and sanitation. Access to improved water and sanitation is not only a precondition to health, but to all aspects of daily living. Target 7.C of the Millennium Development Goals (MDGs) addresses worldwide disparities in access to improved water and sanitation by calling for the reduction in "half of the proportion of people without sustainable access to safe drinking water and sanitation by 2015". Over 90% of the population of …

Trend Analysis And Modeling Of Health And Environmental Data: Joinpoint And Functional Approach, Ram C. Kafle

USF Tampa Graduate Theses and Dissertations

The present study is divided into two parts: the first is on developing the statistical analysis and modeling of mortality (or incidence) trends using Bayesian joinpoint regression and the second is on fitting differential equations from time series data to derive the rate of change of carbon dioxide in the atmosphere.

Joinpoint regression model identifies significant changes in the trends of the incidence, mortality, and survival of a specific disease in a given population. Bayesian approach of joinpoint regression is widely used in modeling statistical data to identify the points in the trend where the significant changes occur. The purpose …

Federal Disaster Declarations And Denials: Analyzing Spatial Equity In The Implementation Of The Stafford Act, Richard Salkowe

USF Tampa Graduate Theses and Dissertations

Federal disaster declarations are authorized by the president under the provisions of the Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1988. Prior studies have found varying levels of political influence associated with the declaration process. Factors including electoral votes, reelection years, congressional committee appointments, geographic location, and party favoritism have been implicated in claims of inequity associated with the distribution of federal disaster assistance. Compounding these concerns is evidence of recurring problems associated with disparities in the long-term recovery from disasters based on social and economic factors. This dissertation is a response to the call for further …

Elective Early Term Delivery And Adverse Infant Outcomes In A Population-Based Multiethnic Cohort, Jason Lee Salemi

USF Tampa Graduate Theses and Dissertations

The length of human pregnancy, arguably the most natural of physiological processes, is undergoing subtle but consequential modification in order to adapt to modern societal demands. The gestational age distribution of births in the United States has been shifting to lower gestational ages over the past two decades, parallel to a concomitant rise in obstetrical intervention in pregnancy. The result has been an increase in elective deliveries at 37-38 weeks (early term).

A population-based retrospective cohort study of over 616,000 live-born full-term singleton infants was conducted to investigate the association between elective early term delivery and subsequent infant morbidity, mortality, …

Is Sickle Cell Trait As Benign As Is Usually Assumed?, Carroll Nicole Flansburg

USF Tampa Graduate Theses and Dissertations

Abstract

Introduction Sickle cell trait carriers may experience sickling events, which can cause severe health problems. Some sickle cell haplotypes contain genetic modifiers that are associated with increased levels of fetal hemoglobin, which is resistant to sickling. The aim of this study is to determine if sickle cell trait individuals who do not carry these modifiers are more likely to experience sickling episodes than those who do carry the modifiers.

Methods: Participants were eligible for inclusion in this study if they were male, 18 years of age or older, a sickle cell trait carrier, and had previously played any level …

Uncontrolled Hypertension And Associated Factors In Hypertensive Patients At The Primary Healthcare Center Luis H. Moreno, Panama: A Feasibility Study, Roderick Ramon Chen Camano

USF Tampa Graduate Theses and Dissertations

Background: According to the World Health Organization (WHO), hypertension is a major risk factor for cardiovascular disease (CVD), renal impairment, peripheral vascular disease, and blindness. In Panama, a recent study estimated the prevalence of hypertension at 38.5% in the two main provinces of the country, with a rate of uncontrolled hypertension of 47.2%.

Objectives: The aims of this study were to assess the feasibility of the study design and to describe the characteristics of the hypertensive population and the physician's adherence to Panamanian antihypertensive protocols and their relationship with uncontrolled hypertension.

Methods: This is a cross-sectional study of adult hypertensive …

Exploring Potential Risk Factors Of Fetal Origins Of Diabetes: Maternal Stressors During Pregnancy And Birth Outcomes Among Women In A Hospital In The Municipality Of Caguas, Puerto Rico, Juan Pablo Arroyo

USF Tampa Graduate Theses and Dissertations

Puerto Rico has the highest prevalence of type 2 diabetes, low birth-weight, and the second highest prevalence of preterm-birth in all the U.S. and its non-incorporated territories. These conditions are related. Birth-weight at both ends of the spectrum and preterm-birth are associated with an increased risk for developing type 2 diabetes and immune-inflammatory dysregulations. Maternal psychosocial stressors during pregnancy have also been recognized as potential risk factors for type 2 diabetes, and have been consistently associated with preterm-birth and low birth-weight across populations. Current evidence points toward epigenetic fetal metabolic-programming as the mechanism that underlies the increased risk for the …

Influence Of Maternal Thyroid Dysfunction On Infant Growth And Development, Ronee Elisha Wilson

USF Tampa Graduate Theses and Dissertations

Thyroid dysfunction is one of the most common endocrine disorders in women of childbearing age and the obstetric consequences of abnormal thyroid hormone levels during pregnancy have been established. Less understood is the implication of the presence of maternal thyroid autoantibodies on infant outcomes among women who are euthyroid during pregnancy. The objective of this study was two-fold: 1) to examine the influence of antenatal thyroperioxidase (TPO) status on fetal/infant brain and body growth measurements at delivery and 2) to explore the relationship of antenatal TPO status and maternal postpartum thyroid dysfunction (PPTD) on early infant growth and neurocognitive development. …

An Analysis Of The Association Between Animal Exposures And The Development Of Type 1 Diabetes In The Teddy Cohort, Callyn Hall

USF Tampa Graduate Theses and Dissertations

Research on exposure to animals and risk of type 1 diabetes (T1D) has had conflicting results with some researchers finding that animal exposure reduces the risk of T1D and others finding no association between animal exposure and T1D. Previously conducted studies on the association between animal exposure and T1D are case-control studies that have been limited by recall bias. The purpose of this study is to investigate the association between early life animal exposure and the risk of persistent, confirmed islet autoantibodies (IA) and T1D diagnosis among an eligible cohort of genetically high T1D risk participants enrolled in the international …