Epidemiology Commons^™

Adherence Barriers To Healthcare For African Americans With Hiv/Aids On Antiretroviral Medications, Angela Bumphus Corbin

Walden Dissertations and Doctoral Studies

The purpose of this mixed methods research study was to examine the role of adherence barriers to healthcare and the impact that such barriers have on highly active antiretroviral therapy (HAART) compliance for African Americans living with HIV/AIDS. HAART helps reduce HIV/AIDS morbidity and mortality. Of the 49% of study participants who had been out of medical care for more than 12 months, financial concerns were listed as the most common barrier (22.8%). Not having the support from family and friends (17.5%), being tired of going to doctor appointments (15.8%), health challenges (12.3%), lack of transportation (12.3%), and incarceration (12.3%) …

Using Administrative Healthcare Records To Identify Determinants Of Amputee Residuum Outcomes, Judith Gail Walden

Walden Dissertations and Doctoral Studies

In the United States, the number of major limb amputees is predicted to exceed several million in the coming decades. For those amputees using a prosthesis, their quality of life (QoL) is often modulated by residuum limb problems resultant from its use. Multiple factors preclude quality evidence-based medicine (EBM) research in the field of prosthetics, leading to greater health risk from prosthetic prescription ambiguity. Positive social change is integral to good QoL; studies support administrative healthcare (AHc) as useful to support such, especially in the absence of EBM. This study utilized Veterans Healthcare Administration (VHA) AHc data to discriminate determinants …

Association Between Physician Characteristics And Surgical Errors In U.S. Hospitals, Obumneke A. Amadi

Walden Dissertations and Doctoral Studies

The high incidence of medical and surgical errors in U.S. hospitals and clinics affects patients' safety. Not enough is known about the relationship between physician characteristics and medical error rates. The purpose of this quantitative correlational study was to examine the relationship between selected physician characteristics and surgical errors in U.S. hospitals. The ecological model was used to understand personal and systemic factors that might be related to the incidence of surgical errors. Archived data from the National Practitioner Data Bank database of physician surgical errors were analyzed using bivariate and multivariate logistic regression analyses. Independent variables included physicians' home …

Predicting Weight Management Advice Behavior Using Social Cognitive Theory Among Psychiatry Professionals, Chidi Chima

Walden Dissertations and Doctoral Studies

Obesity remains a public health concern among persons with mental illness resulting from the interaction of a combination of factors such as genetic, medication, effects of their symptoms, social, and environmental factors. Obesity complications account for increased mortality and morbidity, reduced life expectancy, and quality of life in persons with mental illness. The management of obesity is challenging and predicting the ability of mental health professionals to advise patients on weight management behavior is important to improve patients' overall well-being. The social cognitive theory constructs knowledge, expectations, situational perception, self-efficacy, and goal setting were utilized in predicting Weight Management Advice …

Impact Of Adverse Childhood Experiences On Maternal Health And Birth Weight In Appalachia, Kristen Baker Dickerson

Walden Dissertations and Doctoral Studies

Adverse birth outcomes and adverse childhood experiences (ACE) are concerns in the United States, with potential to impact health indices now and in the future. The purpose of this study was to quantitatively examine the association between maternal exposure to ACE, low birth weight, and county of residence in the Appalachian population using the Life Course Approach as the theoretical framework. A cross-sectional study design and clustering strategy was used to randomly select potential respondents from a data set that was provided by Ohio Department of Health. Self-administered questionnaires were sent to potential respondents to collect information about ACE in …

Type 2 Diabetes Mellitus And Colorectal Cancer Risk And Survival In Oman, Rose Ngozi Mafiana

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) and colorectal cancer (CRC) are 2 chronic diseases with common risk factors related to physical inactivity, obesity, and diet. Literature on T2DM as a risk factor for CRC development and survival in Oman is scarce. Using de-identified archival data provided by Sultan Qaboos University Hospital (SQUH) Oman, a retrospective, case-control, and time-to-event study designs were used to compare odds of developing CRC, and survival rates among adults with and without T2DM. The ecosocial theory provided the theoretical base for this research. Logistic regression was used to examine the odds of developing CRC among 114 cases …

Impact Of Simultaneous Exposure To Arboviruses On Infection And Transmission By Aedes Aegypti Mosquitoes, Claudia Rückert, James Weger-Lucarelli, Selene M. Garcia-Luna, Michael C. Young, Alex D. Byas, Reyes A. Murrieta, Joseph R. Fauver, Gregory D. Ebel

Journal Articles: Epidemiology

The recent emergence of both chikungunya and Zika viruses in the Americas has significantly expanded their distribution and has thus increased the possibility that individuals may become infected by more than one Aedes aegypti-borne virus at a time. Recent clinical data support an increase in the frequency of coinfection in human patients, raising the likelihood that mosquitoes could be exposed to multiple arboviruses during one feeding episode. The impact of coinfection on the ability of relevant vector species to transmit any of these viruses (that is, their vector competence) has not been determined. Thus, we here expose Ae. aegypti mosquitoes …

Mosquitoes Transmit Unique West Nile Virus Populations During Each Feeding Episode, Nathan D. Grubaugh, Joseph R. Fauver, Claudia Rückert, James Weger-Lucarelli, Selene Garcia-Luna, Reyes A. Murrieta, Alex Gendernalik, Darci R. Smith, Doug E. Brackney, Gregory D. Ebel

Journal Articles: Epidemiology

Arthropod-borne viruses (arboviruses), such as Zika virus, chikungunya virus, and West Nile virus (WNV), pose continuous threats to emerge and cause large epidemics. Often, these events are associated with novel virus variants optimized for local transmission that first arise as minorities within a host. Thus, the conditions that regulate the frequency of intrahost variants are important determinants of emergence. Here, we describe the dynamics of WNV genetic diversity during its transmission cycle. By temporally sampling saliva from individual mosquitoes, we demonstrate that virus populations expectorated by mosquitoes are highly diverse and unique to each feeding episode. After transmission to birds, …

Hpv Vaccination And Knowledge Of Cervical Cancer Among Female University Students In A Multiethnic Institution, Usa, Nasar U. Ahmed, Michael E. Delgado, Abraham Degarege

Journal Articles: Epidemiology

Objective: College-aged women are at high-risk of Human Papillomavirus (HPV) infection. Although, HPV vaccination is most effective, its rates remain quite low among college students. It may be due to inadequate understanding of the relationship between HPV and cervical cancer. Therefore, the objective of this study was to examine the level of knowledge about HPV, cervical cancer and their associations with HPV vaccination among female college students.

Methods: Cross-sectional questionnaire based survey was conducted among female students in a Multiethnic University in Florida. We assessed HPV vaccination status, annual health checkup status, knowledge about HPV and cervical cancer among the …

Health Aid In Africa: Placement, Service Utilization, And Benefit, Carrie Dolan

Theses and Dissertations

While the health sector has attracted significant foreign aid, evidence on the effectiveness of this support is mixed. This dissertation examines the allocation of health aid within the context of placement, service utilization, and benefit. The first paper examined the sub-national allocation of Chinese development aid projects across Africa. I determined how political preferencing of Chinese aid specifically, allocating aid to the birth region of the current political leader differs across sectors such as health, education, and transportation. I find some evidence that aid, more broadly defined, is subject to political preferencing in recipient countries, which could potentially limit its …

Depressive Symptoms Among College Students: An Exploration Of Fundamental Cause Theory, Peter A. Carrico

Theses and Dissertations

Fundamental Cause Theory suggests that socioeconomic and demographic factors are causal to various illnesses, including depression. However, no known previously existing research has used Fundamental Cause Theory to create a model of depression among college students. To do this, the present study conducted a stepwise binomial logistic regression to examine how socioeconomic status and the sociodemographic variables of Gender, Race, and Sexual Orientation, and others predict depressive symptoms in a large sample of undergraduates when controlling for stressful life events and social support (N = 2,915). Results support the hypothesis that socioeconomic disparities in depressive symptoms are the result …

Socioecological Aspects Of Tobacco Use In College Populations, Michael D. Sawdey

Theses and Dissertations

Background: Although cigarette smoking is decreasing in the US and among college students, tobacco use remains a major public health problem. Specific socioecological gaps in the literature related to college tobacco use exist including: trends of tobacco use, combinations of polysubstance use, and availability of tobacco products around college campuses.

Objectives: The main goal of this research was the understand interrelationships that exist within a socioecological framework of college tobacco use. Specifically, this project aims to: 1) examine trends of tobacco and polytobacco use by gender and associations of polytobacco use and perceived peer tobacco use, 2) examine …

Person-Centered Treatment To Optimize Psychiatric Medication Adherence, Natalie Bareis

Theses and Dissertations

Objectives: Adherence to psychotropic medication is poor among individuals with bipolar disorder (BD). To understand treatment experiences and associated adherence among these individuals, we developed a novel construct of Clinical Net Benefit (CNB) using psychiatric symptoms, adverse effects and overall functioning assessments. We tested whether adherence differed across classes of CNB, whether individuals transitioned between classes over time, and whether these transitions were differentially associated with adherence.

Methods: Data come from individuals aged 18+ during five years of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Latent class analysis identified groups of CNB. Latent transition analysis determined probabilities of …

Reliability Of Medical Records In Diagnosing Inflammatory Breast Cancer In Egypt, Lynne Le, Catherine Schairer, Ahmed Hablas, Jane L. Meza, Shinobu Watanabe-Galloway, Mohamed Ramadan, Sofia D. Merajver, Ibrahim A. Seifeldin, Amr S. Soliman

Journal Articles: Epidemiology

BACKGROUND: Inflammatory breast cancer (IBC) is a rare, aggressive breast cancer diagnosed clinically by the presence of diffuse erythema, peau d'orange, and edema that arise quickly in the affected breast. This study evaluated the validity of medical records in Gharbiah, Egypt in identifying clinical signs/symptoms of IBC. For 34 IBC cases enrolled in a case-control study at the Gharbiah Cancer Society and Tanta Cancer Center, Egypt (2009-2010), we compared signs/symptoms of IBC noted in medical records to those recorded on a standardized form at the time of IBC diagnosis by clinicians participating in the case-control study. We calculated the sensitivity …

Completion Characteristics Of Non-Hispanic Blacks With Tuberculosis And Hiv, Vernard Darrell Green

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) and human immunodeficiency virus (HIV) are difficult conditions to manage, in tandem they pose even more challenges to public health programs in identifying coinfection to ensure that all TB cases are treated to completion of therapy (COT). The purpose of this study was to test variables that predicted COT among the HIV/TB coinfected population of non-Hispanic, U.S.-born Blacks alive at the time of diagnosis. Social determinants of health were the theoretical foundation used to guide the study based on data from the Report of Verified Cases of TB (RVCT) between 2009 and 2014. Relationships were tested between ethnic/racial …

Delivery Of Health Education In Adolescents With Behavioral Health Challenges, Ashley Akkal, Ransome Eke Md, Phd, Sulin Wu, Amy Rechenberg, Michael Madrid, Jose Lopez-Vera, Duncan Vos

Research Day

BACKGROUND Adolescents with behavioral health issues tend to have inadequate access to health education, and are thus less aware of the importance of personal and dental hygiene, exercise, and healthy diet and lifestyle habits. Due to this disparity, this population has been known to harbor a higher prevalence of STI’s, drug and alcohol abuse, physical altercations, juvenile detention, and suicide attempts. PURPOSE The overall objective of this study was to examine the effect of integrating a health science curriculum in this population. METHODS Participants aged 5-17 years old were recruited and assigned to either control or science groups by Family …

Effects Of A Mindfulness Based Intervention On Diurnal Cortisol In Cancer Survivors, Susannah Small

Theses and Dissertations

Background. There are approximately 15.5 million individuals alive today in the U.S. with a personal history of cancer. For this large and growing population, ill effects associated with cancer diagnosis and treatment include both physical and psychosocial symptoms adversely affecting quality of life. One low-risk alternative to conventional pharmaceutical use in treating these symptoms is mindfulness practice. Research on self-reported measures provides strong evidence that this type of intervention improves quality of life for cancer survivors, but evidence of impact on objective measures is limited. Cortisol, the body’s primary stress hormone, is one relatively easy to measure indicator that …

Assessing The Relationship Between Periodontal Disease And Subsequent Inflammatory Responses And Headache Disorders, Bryn E. Davis

Theses and Dissertations

Headaches are the sixth leading cause of disability worldwide, and the third leading cause of disability amongst those aged 50 and older. Several headache disorders, including migraines, have been associated with nitric oxide production. It is widely accepted that the pain associated with headache disorders is due to the ability of nitric oxide to function as a vasodilator. While nitric oxide is a known vasodilator and has been linked to headache disorder, it is also produced in response to bacterial infections. Periodontal disease is the result of long term bacterial infections occurring in the gum line and nitric oxide is …

A Neighborhood-Wide Association Study (Nwas): Example Of Prostate Cancer Aggressiveness, Shannon M. Lynch, Nandita Mitra, Michelle Ross, Craig Newcomb, Karl Dailey, Tara Jackson, Charnita M. Zeigler-Johnson, Harold Riethman

Medical Diagnostics & Translational Sciences Faculty Publications

Purpose

Cancer results from complex interactions of multiple variables at the biologic, individual, and social levels. Compared to other levels, social effects that occur geospatially in neighborhoods are not as well-studied, and empiric methods to assess these effects are limited. We propose a novel Neighborhood-Wide Association Study(NWAS), analogous to genome-wide association studies(GWAS), that utilizes high-dimensional computing approaches from biology to comprehensively and empirically identify neighborhood factors associated with disease.

Methods

Pennsylvania Cancer Registry data were linked to U.S. Census data. In a successively more stringent multiphase approach, we evaluated the association between neighborhood (n = 14,663 census variables) and prostate …

Impact Of The Childcare Setting And Caregiver Education On Toddler Language Environment, Snejana Nihtianova

Walden Dissertations and Doctoral Studies

Young children's early language development is strongly related to their school performance, and slow language growth may predict later academic problems. The link between the language quality and amount of speech that children hear and their language development is well documented; however, the factors that impact variability in linguistic input are not well understood. The purpose of this quantitative study was to assess the association between childcare settings and childcare provider education level and toddlers' language environment. The study sample consisted of 29 Bulgarian children. The study used a new technology called Language Environment Analysis, which is the preferred method …