Epidemiology Commons^™

Automated Detection Of Infectious Disease Outbreaks In Hospitals: A Retrospective Cohort Study, Susan S. Huang, Deborah S. Yokoe, John Stelling, Hilary Placzek, Martin Kulldorff, Ken Kleinman, Thomas F. O'Brien, Michael S. Calderwood, Johanna Vostok, Julie Dunn, Richard Platt

Public Health Department Faculty Publication Series

BACKGROUND:

Detection of outbreaks of hospital-acquired infections is often based on simple rules, such as the occurrence of three new cases of a single pathogen in two weeks on the same ward. These rules typically focus on only a few pathogens, and they do not account for the pathogens' underlying prevalence, the normal random variation in rates, and clusters that may occur beyond a single ward, such as those associated with specialty services. Ideally, outbreak detection programs should evaluate many pathogens, using a wide array of data sources.

METHODS AND FINDINGS:

We applied a space-time permutation scan statistic to microbiology …

The Mediating Role Of Psychological Distress In The Relationship Between Adverse Childhood Experiences And Adult Smoking, Tara Wynn Strine

Walden Dissertations and Doctoral Studies

While research has indicated that impaired mental health partially mediates the relationship between adverse childhood experiences (ACEs) and alcohol and illicit drug use, little research has examined potential mediators in the relationship between ACEs and smoking, the number one cause of preventable mortality in the United States. Accordingly, this study examined the potential mediating effect of psychological distress on the relationship between ACES and smoking using data from Wave II of the ACE Study, a cross-sectional study completed between June and October of 1997 on a sample of adult health maintenance organization members (N = 7,211). The theoretical underpinnings for …

Immigration And Obesity In African American Adults Residing In The United States, Julius N. Ade

Walden Dissertations and Doctoral Studies

Obesity increases risk for heart disease, hypertension and other chronic diseases, and it affects minority ethnic groups disproportionately. However, it is unknown if African American immigrant adults, an increasing segment of the population, are at higher risk for obesity than African American non-immigrant adults residing in the United States. This study examined the association of obesity and immigrant status by comparing African American immigrant adults now residing in the United States to the general population of African American adults. The socio-ecological model provided the conceptual framework for this study. This study used a cross-sectional quantitative self-administered web-based survey to collect …

The Effect Of Direct Contact On Public Attitudes Towards People Living With Human Immunodeficiency Virus (Hiv) And Acquired Immune Deficiency Syndrome (Aids) In Zimbabweans, Mavis Mashingaidze

Walden Dissertations and Doctoral Studies

Stigma surrounding HIV and AIDS poses a significant threat to the curtailing of the epidemic by acting as a barrier to HIV testing and disclosure of serostatus. Previous research in the United States found personal knowledge of someone with HIV/AIDS to be a predictor of lower levels of HIV/AIDS-related stigma. However, no study to date has examined this relationship in Zimbabweans. Allport's contact hypothesis was hypothesis was the theoretical frame used to assess the effect of direct contact on public attitudes towards people living with the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in Zimbabweans with the …

Clinical Recognition Of Obstructive Sleep Apnea In A Population-Based Sample, Mark R. Zellmer

Walden Dissertations and Doctoral Studies

Obstructive sleep apnea (OSA), a disorder in which the airway intermittently collapses and obstructs during sleep, is associated with increased cardiovascular and cerebrovascular morbidity and mortality, increased risk of motor vehicle accidents, metabolic syndrome, hypertension, and depression. Treatment of OSA attenuates or reverses many of these associated risks. However, most cases of OSA are unrecognized and untreated. The two most recent studies using 1990s data found that only 6.5 - 15.4% of OSA cases, depending on severity, are clinically recognized in mixed gender populations. Based on a conceptual framework of improved physician awareness of OSA, and reduced diagnostic access bias …

Risk Factors For Development Of High Blood Pressure And Obesity Among African American Adolescents, Monique Shanta White

Walden Dissertations and Doctoral Studies

Childhood obesity has reached epidemic proportions in the United States and has been linked to hypertension, especially among African American youth. Optimistic bias leads youth to underestimate their susceptibility to negative health outcomes. Public health officials want to reduce risk factors to result in significant long term reduction in cardiovascular disease. The purpose of this study was to explore adolescent behavior practices in a school district and prevalence of high blood pressure and obesity in that population. The health belief model guided the framework for this study. Research questions examined relationship between individual health risk practices and optimistic bias on …

Program Evaluation For Tdap Immunization Standing Orders In A Birthing Hospital, Helen Crean Taugher

Doctor of Nursing Practice (DNP) Projects

Newborn infants are vulnerable to pertussis infections. Although the Advisory Committee on Immunization Practices (ACIP) recommends that babies begin their diphtheria, tetanus and acellular pertussis (DTaP) immunization series at two months of age, the minimum age for administration of the vaccine is six weeks of age (Centers for Disease Control [CDC], 2008). Young infants are at risk for whooping cough infection transmitted from parents, siblings and care-givers during the pre-vaccination period in the first two months of life, particularly pertussis transmitted from their mothers. Since the licensure of adult/adolescent formulations of tetanus, diphtheria and acellular pertussis (Tdap) vaccine in 2005, …

Serum Antibodies To Human Papillomavirus Type 6, 11, 16 And 18 And Their Role In The Natural History Of Hpv Infection In Men, Beibei Lu

USF Tampa Graduate Theses and Dissertations

Our understanding of humoral immune response to human papillomavirus (HPV) infection has been mainly derived from studies in women. Very little is known about humoral immune response to HPV in men. There is also a growing interest in understanding the burden of HPV exposure in the subgroups of the male population, including men who have sex with women (MSW), men who have sex with men (MSM) and men who have sex with both men and women (MSMW). This dissertation was undertaken to understand and characterize humoral immune response, measured by detectable serum antibody IgG, to HPV 6, 11, 16 and …

The Relationship Between Mosquito Abundance And Rice Field Density In The Republic Of Korea, Erin E. Richards, Penny Masuoka, David Brett-Major, Matthew Smith, Terry A. Klein, Heung Chul Kim, Assaf Anyamba, John Grieco

Journal Articles: Epidemiology

BACKGROUND: Japanese encephalitis virus (JEV), the causative agent of Japanese encephalitis (JE), is endemic to the Republic of Korea (ROK) where unvaccinated United States (U.S.) military Service members, civilians and family members are stationed. The primary vector of the JEV in the ROK is Culex tritaeniorhynchus. The ecological relationship between Culex spp. and rice fields has been studied extensively; rice fields have been shown to increase the prevalence of Cx. tritaeniorhynchus. This research was conducted to determine if the quantification of rice field land cover surrounding U.S. military installations in the ROK should be used as a parameter in a …

Racial /Ethnic Disparities In Hypertension In United States Residents: A Cross-Sectional Study Of Potential Explanatory Covariates, Franklin I. Opara

Walden Dissertations and Doctoral Studies

Racial/ethnic disparities persist in hypertension (HTN) prevalence in the United States, and African Americans are disproportionately affected. The incidence is more than two-folds in African Americans compared to Caucasians, and mortality is highest among African Americans. Understanding the risk factors in HTN and how these factors vary across racial/ethnic groups is essential to reducing the mortality among African Americans. This study examined the prevalence of HTN among a sample non-institutionalized U.S. residents (N = 30,852), assessed racial/ethnic disparities and determined factors associated with racial/ethnic variance in HTN. A cross-sectional design was used to address these aims, utilizing the National Health …

Social Capital Variables As Predictors Of Hiv Risk-Taking Behaviors Among Sub-Saharan African Immigrants In The United States, Gbadebo Ogundiran Ogungbade

Walden Dissertations and Doctoral Studies

Vulnerable populations, including immigrants, are often at risk for human immunodeficiency virus (HIV) infection because of their risk-taking behaviors. This study investigated risk-taking behavior for HIV infection among Sub-Saharan African (SSA) immigrants in United States. Using social capital as a theoretical foundation, the study aimed to address the question, is there any association between social capital assets of educational opportunity, employment, and eligibility for social assistance and HIV risk-taking behavior, defined as condom use before sex (CUBS) among SSA immigrant in the U.S? Potential participants were recruited through religious and social organizations in a southwestern US state. The survey generated …

Recent Diarrhea Is Associated With Elevated Salivary Igg Responses To Cryptosporidium In Residents Of An Eastern Massachusetts Community, A. I. Egorov, L. M. Montuori Trimble, L. Ascolillo, H. D. Ward, Deborah A. Levy, R. D. Morris, E. N. Naumova, J. K. Griffiths

Journal Articles: Epidemiology

BACKGROUND: Serological data suggest that Cryptosporidium infections are common but underreported. The invasiveness of blood sampling limits the application of serology in epidemiological surveillance. We pilot-tested a non-invasive salivary anti-Cryptosporidium antibody assay in a community survey involving children and adults.

MATERIALS AND METHODS: Families with children were recruited in a Massachusetts community in July; symptoms data were collected at 3 monthly follow-up mail surveys. One saliva sample per person (n = 349) was collected via mail, with the last survey in October. Samples were analyzed for IgG and IgA responses to a recombinant C. hominis gp15 sporozoite protein using a …

Malaria And Helminth Co-Infections In Outpatients Of Alaba Kulito Health Center, Southern Ethiopia: A Cross Sectional Study, Abraham Degarege, Abebe Animut, Mengistu Legesse, Berhanu Erko

Journal Articles: Epidemiology

BACKGROUND: Distribution of malaria and intestinal helminths is known to overlap in developing tropical countries of the world. Co-infections with helminth and malaria parasites cause a significant and additive problem against the host. The aim of this study was to asses the prevalence of malaria/helminth co-infection and the associated problems among febrile outpatients that attended Alaba Kulito Health Center, southern Ethiopia November and December 2007. A total of 1802 acute febrile patients were diagnosed for malaria. 458 Giemsa-stained thick and thin blood films were used for identification of Plasmodium species and Stool samples prepared using Kato-Katz technique were used to …

Use Of Outcomes To Evaluate Surveillance Systems For Bioterrorist Attacks, Kerry A. Mcbrien, Ken P. Kleinman, Allyson M. Abrams, Lisa A. Prosser

Public Health Department Faculty Publication Series

Background

Syndromic surveillance systems can potentially be used to detect a bioterrorist attack earlier than traditional surveillance, by virtue of their near real-time analysis of relevant data. Receiver operator characteristic (ROC) curve analysis using the area under the curve (AUC) as a comparison metric has been recommended as a practical evaluation tool for syndromic surveillance systems, yet traditional ROC curves do not account for timeliness of detection or subsequent time-dependent health outcomes.

Methods

Using a decision-analytic approach, we predicted outcomes, measured in lives, quality adjusted life years (QALYs), and costs, for a series of simulated bioterrorist attacks. We then evaluated …

Evidence That Pneumococcal Serotype Replacement In Massachusetts Following Conjugate Vaccination Is Now Complete, William P. Hanage, Jonathan A. Finkelstein, Susan S. Huang, Stephen I. Pelton, Abbie E. Stevenson, Ken Kleinman, Virginia L. Hinrichsen, Christophe Fraser

Public Health Department Faculty Publication Series

Invasive pneumococcal disease (IPD) has been reduced in the US following conjugate vaccination (PCV7) targeting seven pneumococcal serotypes in 2000. However, increases in IPD due to other serotypes have been observed, in particular 19A. How much this "serotype replacement" will erode the benefits of vaccination and over what timescale is unknown. We used a population genetic approach to test first whether the selective impact of vaccination could be detected in a longitudinal carriage sample, and secondly how long it persisted for following introduction of vaccine in 2000. To detect the selective impact of the vaccine we compared the serotype diversity …

Prevention Of Human Papillomavirus (Hpv) Infection And Hpv-Related Diseases : Barriers To Hpv Vaccine Coverage Among University Women In The U.S., And Initial Steps In Integrating Cervical Cytology Testing Into Primary Care In The Republic Of Georgia, Robert Bednarczyk

Legacy Theses & Dissertations (2009 - 2024)

Worldwide, cervical cancer is second only to breast cancer in incidence. Screening for pre-cancerous abnormalities can reduce cervical cancer incidence and mortality, though this is not uniformly used worldwide. Recently, a vaccine against human papillomavirus (HPV), a necessary cause of cervical cancer, was approved for preventive use in the United States.

The Utility Of The Behavioral Risk Factor Surveillance System In Testing Quality Of Life Theory : An Evaluation Using Structural Equation Modeling, Evelyn Marie Kintner

Legacy Theses & Dissertations (2009 - 2024)

This study is a secondary data analysis that uses structural equation modeling (SEM) to assess the utility of the Behavioral Risk Factor Surveillance System (BRFSS)--the Centers for Disease Control's premier surveillance tool for monitoring behavioral risk factors--in predicting health related quality of life (HRQoL). Employing the statistical package SPSS/AMOS (version 7), the study utilizes New York State data extracted from the 2007 BRFSS national dataset to assess how well the observed pattern of variances and covariances of the state level data fit with a well-known HRQoL model developed by Wilson and Cleary (1995). Interaction effects are examined, utilizing a multigroup …

Respondent Driven Sampling : Feasibility, Validation And Its Potential Use For Estimating Health Indicators For Large General Populations, Robin Lee

Legacy Theses & Dissertations (2009 - 2024)

BACKGROUND: Researchers use many methods to collect population-based health indicator data. Random digit dial (RDD) is one frequently used method; however decreasing sample coverage and non-response bias have researchers searching for alternative methods. We hypothesize that respondent driven sampling (RDS) is a cost effective alternative. In accordance with this hypothesis we propose three objectives: 1) assess the mechanics, feasibility, and representativeness of RDS in producing valid estimates of health indicator data; 2) evaluate the feasibility in using RDS in comparison to RDD to collect health indicator data from a general population; and 3) report on data collected using RDS, specifically …

Safety Assessment For Tipranavir : A Protease Inhibitor Treatment For Hiv Infected Adults, Jaromir Mikl

Legacy Theses & Dissertations (2009 - 2024)

Dose-limiting adverse events associated with anti-retroviral therapy (ART) generally include gastro-intestinal (GI) issues such as vomiting and nausea. However, serious adverse events (SAEs) do occur, the most frequent of which include liver toxicities and renal impairment as well as recent evidence of cardio-vascular disease (CVD) risk.

Using Technology And Collaborative Partners For A 2010 Needs Assessment In Tobacco Control, Alice Dalla-Palu Mpa, Ctts-M, Cac, Jeanne Fignar Aas, Meredith Casey B.S.E., Ctts-M, Andreea Ambrus Ms, Anthony Nerino, Deborah Youngfelt Bs,Ches, Ctts,, Trudy Coleman Phd

Department of Medicine

No abstract provided.

Diminishing Availability Of Publicly Funded Slots For Antiretroviral Initiation Among Hiv-Infected Art-Eligible Patients In Uganda, Elvin Geng

Elvin H Geng

No abstract provided.

Tracking A Sample Of Patients Lost To Follow-Up Has A Major Impact On Understanding Determinants Of Survival In Hiv-Infected Patients On Antiretroviral Therapy In Africa, Elvin Geng

Elvin H Geng

No abstract provided.

Características Dos Acidentes De Trânsito Com Vítimas De Atropelamento No Município De Maringá-Pr, 2005-2008 / Characteristics Of Traffic Accidents From 2005 To 2008 With Run Over Victims In Maringá, Pr, Brazil., Everton Fernando Alves

Everton Fernando Alves

Trata-se de um estudo retrospectivo descritivo, que teve por objetivo conhecer as características dos acidentes de trânsito por atropelamento no município de Maringá entre 2005 e 2008. Para o estudo foram consideradas as vítimas de acidentes de trânsito por atro-pelamentos ocorridos em Maringá, no período de 2005 a 2008, através dos dados do Registro Geral de Ocorrência – RGO do 5º Grupamento de Bombeiros (GB). Foram identificadas 1841 vítimas. Do total de víti-mas, foi estudado o número de ocorrências registradas (1486), distribu-ídos em 399 no ano de 2005, 376 em 2006, 361 em 2007 e 350 no ano de 2008. …

Smoking During Pregnancy And Risk Of Abnormal Glucose Tolerance: A Prospective Cohort Study, Amy E. Haskins, Elizabeth R. Bertone-Johnson, Penelope Pekow, Elana Carbone, Renée T. Fortner, Lisa Chasan-Taber

Lisa Chasan-Taber

Background Disturbances in glucose metabolism during pregnancy are associated with negative sequalae for both mother and infant. The association between smoking and abnormal glucose tolerance (AGT) remains controversial. Therefore, the aim of this study was to examine the relationship between smoking prior to and during pregnancy and risk of AGT. Methods We utilized data from a prospective cohort of 1,006 Hispanic (predominantly Puerto Rican) prenatal care patients in Western Massachusetts. Women reported pre- and early pregnancy smoking at recruitment (mean = 15 weeks) and mid pregnancy smoking at a second interview (mean = 28 weeks). AGT was defined as > 135 …

Enhancement Of The Cervical Cancer Screening Program In Malaysia: A Qualitative Study, Tin Tin Su

Tin Tin Su

Introduction: Cervical cancer has long been known as a preventable disease. Yet it still is a prime women's health issue globally. In Malaysia, the current cervical cancer screening program, introduced in the 1960s, has been found to be unsuccessful in terms of Pap smear coverage. The aim of this study is to determine providers perceptives on the program and the feasibility of practicing an organized cervical screening program in Malaysia. Methods: 11 key informant interviews were conducted with policy makers and health care providers from the Ministry of Health in Malaysia from October 2009 to May 2010. Interviewees' perceptions were …

Medicare’S Bundled Reimbursement Policy For Patients With End-Stage Renal Disease, Lisa M. Lines

Lisa M. Lines

No abstract provided.

Estudio Sobre El Comportamiento Y Salud En Los Jóvenes Escolares De La República Dominicana: Resultados De 2009, Juan B. Peña, Elián P. Cabrera-Nguyen, Diana Chaves, Rosa Fernández

Elián P. Cabrera-Nguyen

This scientific report on risk behaviors among adolescents in the Dominican Republic (DR) was prepared for the DR Ministry of Education. The study used a stratified cluster design of public high schools in the DR with sample weights. The questionnaire included items from the 2009 Youth Risk Behavior Survey. Results of this nationally representative survey were presented to a delegation from the DR Ministry of Education at Washington University's Brown School. This report was also presented at the Autonomous University of Santo Domingo. Dr. Juan Peña, assistant professor at Washington University's Brown School, was the PI and is listed as …

The Modified Ncep Atp Iii Criteria Maybe Better Than The Idf Criteria In Diagnosing Metabolic Syndrome Among Malays In Kuala Lumpur, Moy Foong Ming, Awang Bulgiba Awang Mahmud

Moy Foong Ming

Background. Metabolic Syndrome is associated with increased risk for type 2 diabetes and cardiovascular diseases. However, different diagnostic criteria have been recommended by different expert groups. In Malaysia, there is a lack of research comparing these different diagnostic criteria. Therefore, it is our aim to study the concordance between the IDF and the modified NCEP ATP III definitions of Metabolic Syndrome among a Malay cohort in Kuala Lumpur; and to demonstrate if all participants have the same cardiometabolic risks. Methods. This was an analytical cross sectional study. Ethics approval was obtained and informed consent was given by all participants. Anthropometric …