Evaluating A Bystander Intervention Program On Reproductive Coercion: Using Quasi-Experimental Design Strategies To Address Methodologic Issues In Randomized Community Prevention Trials, 2016 University of Kentucky
Evaluating A Bystander Intervention Program On Reproductive Coercion: Using Quasi-Experimental Design Strategies To Address Methodologic Issues In Randomized Community Prevention Trials, Catherine P. Starnes
Theses and Dissertations--Epidemiology and Biostatistics
Community (or cluster) randomized trials are trials in which communities or groups of individuals (clusters) are randomized to receive the intervention of interest. Community randomized trials frequently more closely resemble a natural experiment than a randomized controlled trial (RCT) following intervention allocation. In particular, the effects of non-compliance can pose methodologic challenges in estimating the intervention effect which may require a quasiexperimental approach in order to minimize bias.
The motivating example to illustrate these issues is the Green Dot High School (GDHS) study. The GDHS study was a longitudinal, cluster-randomized controlled trial designed to assess the effectiveness of a bystander …
Male Pattern Baldness In Relation To Prostate Cancer–Specific Mortality: A Prospective Analysis In The Nhanes I Epidemiologic Follow-Up Study, 2016 George Washington University
Male Pattern Baldness In Relation To Prostate Cancer–Specific Mortality: A Prospective Analysis In The Nhanes I Epidemiologic Follow-Up Study, Cindy Ke Zhou, Paul H Levine, Sean D. Cleary, Heather J. Hoffman, Barry I Graubard, Michael B. Cook
Epidemiology Faculty Publications
We used male pattern baldness as a proxy for long-term androgen exposure and investigated the association of dermatologist-assessed hair loss with prostate cancer–specific mortality in the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. From the baseline survey (1971–1974), we included 4,316 men who were 25–74 years of age and had no prior cancer diagnosis. We estimated hazard ratios and used Cox proportional hazards regressions with age as the time metric and baseline hazard stratified by baseline age. A hybrid framework was used to account for stratification and clustering of the sample design, with adjustment for the variables …
Importance Of Hereditary And Selected Environmental Risk Factors In The Etiology Of Inflammatory Breast Cancer: A Case-Comparison Study., 2016 George Washington University
Importance Of Hereditary And Selected Environmental Risk Factors In The Etiology Of Inflammatory Breast Cancer: A Case-Comparison Study., Roxana Moslehi, Elizabeth Freedman, Nur Zeinomar, Carmela Veneroso, Paul H. Levine
Epidemiology Faculty Publications
BACKGROUND: To assess the importance of heredity in the etiology of inflammatory breast cancer (IBC), we compared IBC patients to several carefully chosen comparison groups with respect to the prevalence of first-degree family history of breast cancer.
METHODS: IBC cases (n = 141) were compared to non-inflammatory breast cancer cases (n = 178) ascertained through George Washington University (GWU) with respect to the prevalence of first-degree family history of breast cancer and selected environmental/lifestyle risk factors for breast cancer. Similar comparisons were conducted with subjects from three case-control studies: breast cancer cases (n = 1145) and unaffected controls (n = …
Socioecological Factors Influencing Women's Hiv Risk In The United States: Qualitative Findings From The Women's Hiv Seroincidence Study (Hptn 064)., 2016 George Washington University
Socioecological Factors Influencing Women's Hiv Risk In The United States: Qualitative Findings From The Women's Hiv Seroincidence Study (Hptn 064)., Paula M Frew, Kimberly Parker, Linda Vo, Danielle Haley, Ann O'Leary, Dazon Dixon Diallo, Carol E Golin, Irene Kuo, Lydia Soto-Torres, Jing Wang, Adaora A Adimora, Laura A Randall, Carlos Del Rio, Sally Hodder, Hiv Prevention Trials Network 064 (Htpn) Study Team.
Epidemiology Faculty Publications
BACKGROUND: We sought to understand the multilevel syndemic factors that are concurrently contributing to the HIV epidemic among women living in the US. We specifically examined community, network, dyadic, and individual factors to explain HIV vulnerability within a socioecological framework.
METHODS: We gathered qualitative data (120 interviews and 31 focus groups) from a subset of women ages 18-44 years (N = 2,099) enrolled in the HPTN 064 HIV seroincidence estimation study across 10 US communities. We analyzed data from 4 diverse locations: Atlanta, New York City (the Bronx), Raleigh, and Washington, DC. Data were thematically coded using grounded theory methodology. …
Interruptions Of Antiretroviral Therapy In Children And Adolescents With Hiv Infection In Clinical Practice: A Retrospective Cohort Study In The Usa., 2016 George Washington University
Interruptions Of Antiretroviral Therapy In Children And Adolescents With Hiv Infection In Clinical Practice: A Retrospective Cohort Study In The Usa., Natella Rakhmanina, Kam S Lam, Jaclyn Hern, Heather A. Young, Alex Walters, Amanda D. Castel
Epidemiology Faculty Publications
INTRODUCTION: Changes in combination antiretroviral therapy (cART) throughout childhood challenge the continuity of paediatric HIV treatment. This study aimed to evaluate the prevalence of treatment interruption (TI), including lamivudine (3TC) monotherapy, and the relationship of TI to virologic and immunologic parameters in HIV-infected paediatric patients.
METHODS: Nested within a prospective observational study of a city-wide cohort of HIV-infected persons in the District of Columbia, this sub-study collected retrospective data on antiretroviral therapy, enrolment (endpoint) and historic (lifelong) CD4 counts and HIV RNA viral load (VL) of the paediatric cohort. TI was defined as interruption of cART ≥4 consecutive weeks. Data …
Improving Hiv Surveillance Data For Public Health Action In Washington, Dc: A Novel Multiorganizational Data-Sharing Method, 2016 George Washington University
Improving Hiv Surveillance Data For Public Health Action In Washington, Dc: A Novel Multiorganizational Data-Sharing Method, Joanne Ocampo, J. C. Smart, Adam Allston, Reshma Bhattacharjee, Sahithi Boggavarapu, Amanda D. Castel, +13 More
GW Biostatistics Center
Background: The National HIV/AIDS Strategy calls for active surveillance programs for human immunodeficiency virus (HIV) to more accurately measure access to and retention in care across the HIV care continuum for persons living with HIV within their jurisdictions and to identify persons who may need public health services. However, traditional public health surveillance methods face substantial technological and privacy-related barriers to data sharing.
Objective: This study developed a novel data-sharing approach to improve the timeliness and quality of HIV surveillance data in three jurisdictions where persons may often travel across the borders of the District of Columbia, Maryland, and Virginia. …
D-Dimer Levels Before Hiv Seroconversion Remain Elevated Even After Viral Suppression And Are Associated With An Increased Risk Of Non-Aids Events, 2016 George Washington University
D-Dimer Levels Before Hiv Seroconversion Remain Elevated Even After Viral Suppression And Are Associated With An Increased Risk Of Non-Aids Events, Matthew S Freiberg, Ionut Bebu, Russell Tracy, Kaku So-Armah, Jason Okulicz, Anuradha Ganesan, Adam Armstrong, Thomas O'Bryan, David Rimland, Amy C Justice, Brian K Agan
GW Biostatistics Center
The mechanism underlying the excess risk of non-AIDS diseases among HIV infected people is unclear. HIV associated inflammation/hypercoagulability likely plays a role. While antiretroviral therapy (ART) may return this process to pre-HIV levels, this has not been directly demonstrated. We analyzed data/specimens on 249 HIV+ participants from the US Military HIV Natural History Study, a prospective, multicenter observational cohort of >5600 active duty military personnel and beneficiaries living with HIV. We used stored blood specimens to measure D-dimer and Interleukin-6 (IL-6) at three time points: pre-HIV seroconversion, ≥6 months post-HIV seroconversion but prior to ART initiation, and ≥6 months post-ART …
Significance Of Epicardial And Intrathoracic Adipose Tissue Volume Among Type 1 Diabetes Patients In The Dcct/Edic: A Pilot Study., 2016 George Washington University
Significance Of Epicardial And Intrathoracic Adipose Tissue Volume Among Type 1 Diabetes Patients In The Dcct/Edic: A Pilot Study., Sirous Darabian, Jye-Yu C Backlund, Patricia A Cleary, Nasim Sheidaee, Ionut Bebu, John M. Lachin, Matthew J Budoff, Dcct/Edic Research Group
GW Biostatistics Center
Introduction
Type 1 diabetes (T1DM) patients are at increased risk of coronary artery disease (CAD). This pilot study sought to evaluate the relationship between epicardial adipose tissue (EAT) and intra-thoracic adipose tissue (IAT) volumes and cardio-metabolic risk factors in T1DM.
Method
EAT/IAT volumes in 100 patients, underwent non-contrast cardiac computed tomography in the Diabetes Control and Complications Trial /Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study were measured by a certified reader. Fat was defined as pixels’ density of -30 to -190 Hounsfield Unit. The associations were assessed using–Pearson partial correlation and linear regression models adjusted for gender and age …
Do Health Reforms Impact Cost Consciousness Of Health Care Professionals? Results From A Nation-Wide Survey In The Balkans, 2016 New York Medical College
Do Health Reforms Impact Cost Consciousness Of Health Care Professionals? Results From A Nation-Wide Survey In The Balkans, Mihajlo Jakovljevic, Mira Vukovic, Chia-Ching Chen, Tetsuji Yamada
NYMC Faculty Publications
BACKGROUND: Serbia, as the largest market of the Western Balkans, has entered socioeconomic transition with substantial delay compared to most of Eastern Europe. Its health system reform efforts were bold during the past 15 years, but their results were inconsistent in various areas. The two waves of global recession that hit Balkan economies ultimately reflected to the financial situation of healthcare. Serious difficulties in providing accessible medical care to the citizens became a reality. A large part of the unbearable expenses actually belongs to the overt prescription of pharmaceuticals and various laboratory and imaging diagnostic procedures requested by physicians. Therefore, …
Association Between Haart And Metabolic Syndrome Components Among Hiv-Positive Adults In Southeastern Nigeria, 2016 Walden University
Association Between Haart And Metabolic Syndrome Components Among Hiv-Positive Adults In Southeastern Nigeria, Bridget Okiemute Amechi
Walden Dissertations and Doctoral Studies
Highly active antiretroviral therapy (HAART) contributes to metabolic disorders and the growing prevalence of metabolic syndrome (MetS) in human immunodeficiency virus (HIV)-infected patients. Hypertension, obesity, and hyperglycemia (components of MetS) are risk factors for cardiovascular disease. Studies have shown that HIV patients on HAART have a 2-fold risk of dying from MetS. There are no such studies in Umuahia; hence the need for this study to fill this gap. Using a sample size of 192 medical records of HIV-infected patients in Federal Medical Centre, Umuahia, and applying metabolic syndrome theory, this study examined the relationships among types of HAART regimen, …
Prevalence Of Nasal Colonization By Methicillin-Resistant Staphylococcus Aureus In Persons Using A Homeless Shelter In Kansas City, 2016 Children's Mercy Hospital
Prevalence Of Nasal Colonization By Methicillin-Resistant Staphylococcus Aureus In Persons Using A Homeless Shelter In Kansas City, Megan Ottomeyer, Charles D. Graham, Avery D. Legg, Elizabeth S. Cooper, Chad D. Law, Mariam Molani, Karine Matevossian, Jerry Marlin, Charlott Williams, Ramon Newman, Jason A. Wasserman, Larry W. Segars, Tracey A H Taylor
Manuscripts, Articles, Book Chapters and Other Papers
Nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA) plays an important role in the epidemiology and pathogenesis of disease. Situations of close-quarter contact in groups are generally regarded as a risk factor for community-acquired MRSA strains due to transmission via fomites and person-to-person contact. With these criteria for risk, homeless individuals using shelter facilities, including showers and toilets, should be considered high risk for colonization and infection. The aim of this study was to determine the prevalence of nasal colonization of MRSA in a homeless population compared to established rates of colonization within the public and a control group of subjects …
Association Between Social Integration And Health Among Internal Migrants In Zhongshan, China, 2016 Old Dominion University
Association Between Social Integration And Health Among Internal Migrants In Zhongshan, China, Yanwei Lin, Qi Zhang, Wen Chen, Jingrong Shi, Siqi Han, Xiaolei Song, Yong Xu, Li Ling
Community & Environmental Health Faculty Publications
Internal migrants are the individuals who migrate between regions in one country. The number of internal migrants were estimated at 245 million in China in 2013. Results were inconsistent in the literature about the relationship between their health statuses and social integration. The main difference exists on how to measure the social integration and whether health statuses of internal migrants improve with years of residence. To complement the existing literature, this study measured social integration more comprehensively and estimated the internal migrants' health statuses with varying years of residence, and explored the associations between the migrants' social integration and health. …
Epidemiology Of Pediatric Prehospital Basic Life Support Care In The United States, 2016 Old Dominion University
Epidemiology Of Pediatric Prehospital Basic Life Support Care In The United States, Leigh Ann Diggs, Manasi Sheth-Chandra, Gianluca De Leo
Community & Environmental Health Faculty Publications
Children have unique medical needs compared to adults. Emergency medical services personnel need proper equipment and training to care for children. The purpose of this study is to characterize emergency medical services pediatric basic life support to help better understand the needs of children transported by ambulance. Pediatric basic life support patients were identified in this retrospective descriptive study. Descriptive statistics were used to examine incident location, possible injury, cardiac arrest, resuscitation attempted, chief complaint, primary symptom, provider's primary impression, cause of injury, and procedures performed during pediatric basic life support calls using the largest aggregate of emergency medical services …
Lifestyle Contributors To Cardiovascular Disease Risk, 2016 University of Kentucky
Lifestyle Contributors To Cardiovascular Disease Risk, Adam J. Berrones
Theses and Dissertations--Kinesiology and Health Promotion
Aortic stiffness is an independent risk factor that has prognostic value regarding future cardiovascular disease (CVD) events such as myocardial infarction, strokes, and heart failure. Although death rates due to coronary heart disease have declined in recent years, the leading global killer remains CVD and prevalence is still high. Understanding lifestyle contributors associated with aortic stiffness would provide the public with insight into targeting key health-related behaviors.
The purpose of this observational study was to examine the association of physical activity, physical function, and dietary quality as independent factors contributing to aortic stiffness in apparently healthy middle aged men. Fifty-two …
Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, 2016 Walden University
Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, Kathy Bianco
Walden Dissertations and Doctoral Studies
Alzheimer's disease (AD) is the 6th leading cause of death in older Americans. Currently there is no cure for AD, and even though the specific cause is unknown, diabetes mellitus type 2 (DM2) is regarded as a risk factor. Hispanics have a higher incidence of DM2 and possibly AD. I chose a life course theoretical model for this quantitative cross-sectional study to illuminate the variables most pertinent to a pathway from good health to poor health. The variables chosen were hypertension (HTN), obesity, smoking, stroke, dyslipidemia, and lower educational attainment. The research questions were used to examine biologic, metabolic, sociologic, …
Hiv-Positive Status Disclosure Barriers In Stable Heterosexual Partners In Warri, Nigeria., 2016 Walden University
Hiv-Positive Status Disclosure Barriers In Stable Heterosexual Partners In Warri, Nigeria., Edith Nkechinyere Ogbozor
Walden Dissertations and Doctoral Studies
Nondisclosure of positive status drives the secondary transmission of human immunodeficiency virus (HIV) infection. This cross sectional quantitative survey study grounded by the consequence theory evaluates fear of stigma, lack of social support, and level of HIV-related knowledge as barriers to self-disclosure of HIV-positive status to stable heterosexual partners. A sample of 303 HIV-infected respondents (111 men and 192 women) accessing antiretroviral therapy at 4 designated centers in Warri, Nigeria, completed the self-administered questionnaires. Logistic regression analysis was used to assess the association between these factors and spousal HIV-positive status disclosure. Results demonstrated: (a) social support availability significantly predicted HIV …
Relationships Of Chronotype, Social Jetlag, Sleep, Physical Activity And Diet With Mood, Perceived Stress, Obesity, Blood Pressure And Prostate Cancer, 2016 University of South Carolina
Relationships Of Chronotype, Social Jetlag, Sleep, Physical Activity And Diet With Mood, Perceived Stress, Obesity, Blood Pressure And Prostate Cancer, Daria M. Mcmahon
Theses and Dissertations
Background: Chronotype, social jetlag, poor sleep, proinflammatory diet, and low physical activity have been associated with increased risk of chronic diseases: obesity, diabetes, cardiovascular disease, depression and cancer. Yet the relationships between these factors have not been extensively investigated in prospective studies.
Methods: Two studies were conducted. The first study followed 390 healthy men and women ages 21-35 for two years. Social jetlag [SJL] and sleep measures (total sleep time [TST], sleep onset latency [SOL], wake after sleep onset [WASO]), sleep efficiency [SE]), were derived from physical activity personal (armband) monitoring. The participants wore the armband for 4-10 …
Association Between Biopsychosocial Factors And Physical Activity Among U.S. Stroke Survivors, 2016 Walden University
Association Between Biopsychosocial Factors And Physical Activity Among U.S. Stroke Survivors, Claire Johnson
Walden Dissertations and Doctoral Studies
Stroke causes substantial morbidity and mortality, and physical activity can reduce the risk of stroke occurrence. The purpose of this study was to test the association between biopsychosocial factors and levels of physical activity and to develop a model to predict inactivity for US stroke survivors. A quantitative, cross-sectional analysis was performed of the 2013 National Health Interview Survey (NHIS), which is a representative sample of US households. Association for 1,077 stroke survivors was tested with chi-square between physical activity and independent variables: biological factors (age, sex, race, body mass index, musculoskeletal conditions, and cardiovascular diseases), psychological factors (mental distress, …
Risk Factors For Tuberculosis And Multidrug-Resistant Tuberculosis Complications Among Foreign-Born Persons In Houston, Texas, 2016 Walden University
Risk Factors For Tuberculosis And Multidrug-Resistant Tuberculosis Complications Among Foreign-Born Persons In Houston, Texas, James N. Isaboke
Walden Dissertations and Doctoral Studies
Tuberculosis (TB) is a leading public health problem across the world. For various reasons, TB and multidrug-resistant tuberculosis (MDR-TB) have increased. Clarification on TB/HIV co-infection and homelessness as risk factors for TB and MDR-TB is required to inform policy interventions to reduce TB-related morbidity, mortality, and healthcare costs. In this quantitative study, data from the Houston Health Department (N = 341) were analyzed to explore the relationship between TB and MDR-TB outcomes and TB/HIV co-infection and type of housing/homelessness. Foreign-born persons are disproportionately affected in the United States. The socio-ecological model provided a theoretical framework for the investigation. Multiple and …
Incidence And Factors Associated With Nonalcoholic Fatty Liver Disease Among Patients With Rheumatoid Arthritis, 2016 Walden University
Incidence And Factors Associated With Nonalcoholic Fatty Liver Disease Among Patients With Rheumatoid Arthritis, Ani K. John
Walden Dissertations and Doctoral Studies
Nonalcoholic fatty liver disease (NAFLD) has become one of the most common hepatic diseases worldwide, making the diagnosis and management of NAFLD an emerging public health issue. Theories associated with NAFLD surmise that inflammation may be the root cause, along with the complex interplay of other chronic conditions such as obesity, metabolic syndrome, diabetes, dyslipidemia, and cardiovascular disease (CVD). It is unknown if other inflammatory conditions such as rheumatoid arthritis (RA), along with the use of methotrexate (MTX), might confer increased risk for NAFLD. Longitudinal data collected from a retrospective cohort of 17,481 adult RA patients in the United States …