Epidemiology Commons^™

Management And Outcomes Of Renal Disease And Acute Myocardial Infarction, Paul Santolucito, Dennis Tighe, David Mcmanus, Jorge Yarzebski, Darleen Lessard, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Contemporary trends in the management and outcomes of chronic kidney disease patients who develop an acute myocardial infarction have not been adequately described, particularly from the more generalizable perspective of a population-based investigation. METHODS: The study population consisted of 6219 residents of the Worcester, Massachusetts, metropolitan area who were hospitalized with acute myocardial infarction in 6 annual periods between 1995 and 2005. Patients were categorized as having preserved kidney function (n=3154), mild to moderate chronic kidney disease (n=2313), or severe chronic kidney disease (n=752) at the time of hospital admission. RESULTS: Patients with chronic kidney disease were more likely …

Spatial Distribution Of Commercial Banks In Ilorin Metropolis, Kwara State, Nigeria, I B. Abdullahi, M A. Ijaiya, A Abdulraheem, R I. Abdulkadir, R O. Ibrahim

Confluence Journal of Environmental Studies (CJES), Kogi State University, Nigeria

The spatial distribution of banks in any geographic entity determines the level of accessibility to its services by the public. This study examined the pattern of banks distribution in Ilorin metropolis. Field survey was employed in determining the number of available commercial banks and their respective distances between each other. The spatial analysis technique such as the nearest neighbour analysis as used ascertain the degree of clustering, density and the average distance taken to access these services. The study revealed that about 96% of the total number of banks are situated in the Central Business District which exhibited a very …

Education, Occupation, And Migration As Predictors Of Multiple Sexual Partnerships Among People Tested For Hiv In Luderitz, Namibia, Sima Blank

Masters Theses 1911 - February 2014

Multiple sexual partnerships are associated with greater risk of HIV, sexually transmitted infections (STIs) and intimate partner violence. Namibia has an HIV prevalence of 18% and surveys have shown that up to 40% of men in parts of the country have multiple sexual partners; however, no studies have evaluated characteristics associated with this behavior.

We evaluated the relationship between education, occupation, and migration and multiple sexual partnerships among people tested for HIV in Lüderitz, Namibia. Data are taken from a cross-sectional study of 570 men and women conducted in a Voluntary Counseling and Testing Center from September-November 2009. Multinomial logistic …

Density Of Drinking Establishments And Hiv Prevalence In A Migrant Town In Namibia, Brooke E. Nichols

Masters Theses 1911 - February 2014

Given the established link between alcohol consumption and risk taking behavior, it is plausible that neighborhoods with higher density of drinking establishments will be associated with increased prevalence of HIV. We conducted an ecological study comparing neighborhoods in Luderitz, Namibia, to evaluate this relationship. We observed increased prevalence of HIV comparing high densities of registered and unregistered shebeens, bars, and total number of drinking establishments, as compared with low densities, were associated with increased prevalence of HIV (PR=3.02, 95% CI: 2.04-4.47; PR=1.71, 95% CI: 1.42-2.07; PR=1.55, 95% CI: 1.19-2.02). Our observation of increased prevalence associated with higher densities of drinking …

Beverage Consumption And Body Composition Among College-Aged Women, Matthew Sloan

Masters Theses 1911 - February 2014

In the U.S., over 67 million adults are obese and 300,000 annual deaths are related to obesity. Among college-aged women, over 60% report daily consumption of caloric beverages. Prior studies indicate positive associations between these beverages and obesity, but conflicting results for diet drinks. Studies were limited, however, by obesity measures that failed to accurately assess abdominal adiposity or percent body fat, and few studies included college-aged women.

We examined this relationship among participants aged 18-30 in the University of Massachusetts Vitamin D Status Study (n=237). We assessed average diet in the past two months using a modified …

Selective Serotonin Reuptake Inhibitors And Bone Mineral Density In A Population Of U. S. Premenopausal Women, Lori J. Peterson

Masters Theses 1911 - February 2014

Selective Serotonin Reuptake Inhibitors and Bone mineral Density in a Population of U.S. Premenopausal Women

May 2011

M.S., UNIVERSITY of Massachusetts Amherst

Directed by: Professor Elizabeth R. Bertone-Johnson

Low bone mineral density (BMD) in post-menopausal women is a risk factor for bone fractures and osteoporosis development. Prior studies in post-menopausal women have shown the use of antidepressant medications, specifically selective serotonin reuptake inhibitors (SSRIs) to be inversely related to BMD. However, the association has not been studied in pre-menopausal women. Current SSRI use is widespread with 8% of U.S. women age 18-44 reporting use. We evaluated the association between SSRIs …

The Association Between Vitamin D And Depression Among College-Aged Women, Constance M. Barysauskas

Masters Theses 1911 - February 2014

Approximately 15 million Americans are diagnosed with a major depressive disorder each year, with higher rates among women and college-aged adults. Recent research suggests a vitamin D insufficiency may be associated with an increased risk of depression among the elderly. However, studies have not been conducted among young women. A recent study of young adults in Massachusetts suggests that two-thirds of this population is vitamin D deficient. We evaluated the association between dietary vitamin D intake and serum levels of 25-hydroxyvitamin D (25(OH)D₃) and history of depression using data from the UMass Vitamin D Status Study, a cross-sectional …

The Association Between Measures Of Adiposity And Anovulation In Women With Regular Menstural Cycles, Nicole Ash

Masters Theses 1911 - February 2014

Anovulation accounts for approximately 12 percent of all female infertility in the United States. Prior studies suggest women with high body mass index (BMI) have an increased risk of infertility, particularly obese women with abnormal cycle lengths. To date no studies have examined the relationship between measures of adiposity, including BMI and percent body fat measured by DXA scan (%BF), and anovulation among women with regular menstrual cycles assessed with biomarkers. We evaluated this association using data from the BioCycle study, a prospective cohort of 259 women with regular menstrual cycles. All measures of adiposity and covariates were collected at …

Vitamin D Levels And Risk Of Dyslipidemia Among Us Children With Diabetes And Obesity, Elsina E. Hagan

Masters Theses 1911 - February 2014

Dyslipidemia is increasing among U.S. children, and the prevalence is highest among children with diabetes and obesity. Recently, vitamin D deficiency has been suggested as a possible dietary risk factor for dyslipidemia. Despite the high prevalence of vitamin D deficiency amongst children, virtually no studies have evaluated the association between vitamin D and dyslipidemia among children. We evaluated the vitamin D and dyslipidemia relationship among 240 children and adolescents aged 2 through 21 years who were outpatients of a pediatric endocrinology unit at a large tertiary care facility in Western Massachusetts from April 2008 to April 2010. Eligible children were …

Perineal Talc Use And Risk Of Endometrial Cancer In Postmenopausal Women, Lori B. Crawford

Masters Theses 1911 - February 2014

Endometrial cancer is the most common female reproductive cancer in the United States. Most known risk factors for endometrial cancer are either genetic or related to exposure to estrogens; less is known about risk due to environmental exposures. While several studies have examined the relationship between perineal powder use and ovarian cancer risk, only one study has addressed the relationship with endometrial cancer risk. The Women's Health Initiative Observational Study, a prospective cohort study of 93,676 United States postmenopausal women from 1993-2005, measured perineal powder use at baseline via self-report. Cases of endometrial cancer were self-reported and confirmed by both …

A Retrospective Population Based Cohort Study Examining The Black White Gap In Infant Mortality, Ina Marie Peoples

Presidential Alumni Research Dissemination Award

Black women in one US City have more than a 2-fold likelihood of experiencing a death in the womb or an infant death within the first year of life when compared to Whites. The purpose of this retrospective population based cohort study was to examine the unexplained high rates of Black fetal and infant (feto-infant) mortality in this city. The study was built on the perinatal periods of risk (PPOR) model. The PPOR model maps each death in a geographic region into four distinct periods of risk based on birth weight and age at death. The study relied upon 51,303 …

Angiogenic Biomarkers For Risk Stratification In Women With Suspected Preeclampsia, Andreea Balan, Heather Young, Linda Ojo, Jennifer Keller, Sharon Maynard

Epidemiology Faculty Posters and Presentations

This poster presents the results of a single-center prospective cohort study of 315 pregnant women who presented to George Washington University Hospital Labor and Delivery service with a clinical suspicion of preeclampsia between February 2007 and November 2011. Informed consent was obtained. Baseline demographic information and medical history was collected on each patient including maternal age, ethnicity, body mass index, tobacco and other substance use, gestational age, medical problems and obstetric history. Serum samples were obtained from each enrolled subject within 24 hours of admission, and sFlt1, PlGF and sEng ELISA assays were performed in duplicate by a blinded laboratory …

Prevalence Of Thyroid Disorders Among Older People: Results From The São Paulo Ageing & Health Study, Paulo A. Lotufo

Paulo A Lotufo

This study aimed to estimate prevalence of thyroid disorders in the São Paulo Ageing & Health Study, an epidemiological study addressing several health-adverse outcomes among elderly people living in a poor area of São Paulo, Brazil. All participants answered a questionnaire and had a blood sample collected to assess levels of tireotropic hormone and free-thyroxine. Among 1,373 people (60.8% women), prevalence rates (95% confidence interval) for thyroid dysfunction (%) were: overt hyperthyroidism, 0.7% (0.2-1.1) [women: 0.8% (0.2-1.5); men: 0.4% (0.01-0.9)]; overt hypothyroidism, 5.7% (4.5-6.9) [women: 5.9% (4.3-7.5); men: 5.4% (3.5-7.3)]; subclinical hyperthyroidism, 2.4% (1.6-3.2) [women: 2.8% (1.6-3.9); men: 1.9% (0.7-3.0)]; …

Vaccine Liability In The Supreme Court: Forging A Social Compact, John D. Kraemer, Lawrence O. Gostin

John D Kraemer

In its decision in Bruesewitz v. Wyeth LLC, the Supreme Court ruled that state products liability suits that allege design defects in vaccines are preempted by the National Childhood Vaccine Injury Act. This decision, the third in a trilogy of Supreme Court preemption cases that deal with products liability suits for health commodities, preserves the Vaccine Injury Compensation Program and the delicate balance between ensuring the vaccine supply and compensating injuries that it enables. Failing to preempt state product liability suits would have exposed vaccine manufacturers to substantial litigation costs defending unfounded claims about autism.

Adaptive Responses To Flooding Incidents In Ilorin, Kwara State, Nigeria, Habiba I. Jimoh, Kayode A. Iroye

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Incidents of floods which are mainly caused by changes in landuse is fast becoming a city life experience in Ilorin as in most urban centres in Nigeria causing untold hardships and sometimes loss of lives. This extreme hydro-meteorological event is also being exacerbated by climate change which thus calls for adaptive response by residents towards reducing its risks, hence this study. Data used were generated from direct field measurements and questionnaire administration. Descriptive statistics and cross tabulations were used in analyzing the data. Results obtained indicate that most respondents use a wide range of non-structural adaptive response to flood. The …

An Assessment Of Socio-Economic Impact Of Waste Scavenging As A Means Of Poverty Alleviation In Gwagwalada, Abuja., John Yakubu Magaji, Samuel Panse Dakyes

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Waste scavengers are usually perceived as being among the poor, and scavenging is considered a marginal activity. They tend to have low incomes, but can obtained decent earning when they are not exploited by middlemen. This study was conducted in Gwagwalada town with the aim of assessing the socio-economic impact of scavenging on the people. A structured questionnaire was constructed to capture the demographic characteristics of the scavengers, their experiences, types of items scavenged, the economic gains and the challenges being faced. The target pollution is waste scavengers and a random sampling technique was adopted in selecting the respondents for …

Medical Encounter Characteristics Of Hiv Seroconverters In The Us Army And Air Force, 2000–2004, Shilpa Hakre, David Brett-Major, Darrell E. Singer, Robert J. O'Connell, Warren B. Sateren, Jose L. Sanchez, Brian K. Agan, Nelson L. Michael, Paul T. Scott

Journal Articles: Epidemiology

BACKGROUND AND METHODS: Active duty US Army and Air Force military personnel undergo mandatory biennial HIV antibody screening. We compared pre- and post-HIV seroconversion health status by conducting a case-control study, which evaluated all medical encounters and sociodemographic factors among incident HIV seroconverters and HIV-negative controls from June 2000 through February 2004.

RESULTS: A total of 274 HIV seroconverters and 6205 HIV-negative personnel were included. In multivariate analysis restricted to male personnel (cases = 261, controls = 5801), single marital status (adjusted odds ratio [AOR] = 14.37), clinical indicators or symptoms within four years of HIV diagnosis (AOR = 6.22), …

Optimal Control Applied To A Discrete Time Influenza Model, Paula Andrea Gonzalez Parra

Open Access Theses & Dissertations

For the last decades, mathematical epidemiological models have been used to understand the dynamics of infectious diseases and guide public health policy.

In particular, several continuous models have been considered to study influenza outbreaks and their controls policies. However, most epidemiological data is discrete; therefore, a discrete formulation is more convenient to compare collected data with the output of the model. We introduce a discrete time model in order to study optimal control strategies for influenza transmission.

In our model, we divide the population into four classes: susceptible, infectious, treated, and recovered individuals.

In particular, we evaluate the potential effect …

An Investigation Of The Subtype Diversity Of Clinical Isolates Of Irish Clostridium Difficile Ribotypes 027 And 078 By Repetitive-Extragenic Palindromic Pcr, Denise Drudy, K. Solomon, S. Murray, L. Scott, S. Mcdermott,, A. Martin, C. O’Donoghue, M. Skally, K. Burns, L. Fenelon, F. Fitzpatrick,, L. Kyne, S. Fanning

Articles

A repetitive-extragenic palindromic PCR (rep-PCR) subtyping method (DiversiLab) in conjunction with ribotyping, toxinotyping and antimicrobial-susceptibility testing was used to detect subtypes within Clostridium difficile ribotypes 027 and 078. Clinical isolates of ribotypes 027 (toxinotype III) (n530) and 078 (toxinotype V) (n523) were provided by health-care facilities across the Republic of Ireland over 2 months in 2006 and 1 month in 2009. Ribotype 027 isolates were significantly more related to each other (9 different subtype profiles) when compared to ribotype 078 isolates (14 different profiles) (P50.001; cut-off .90 % similarity). Almost half of ribotype 078 isolates (45.5 %) showed no relationship …

Kriged And Modeled Ambient Air Levels Of Benzene In An Urban Environment: An Exposure Assessment Study, Kristina W. Whitworth, Elaine Symanski, Dejian Lai, Ann L. Coker

CRVAW Faculty Journal Articles

Background. There is increasing concern regarding the potential adverse health effects of air pollution, particularly hazardous air pollutants (HAPs). However, quantifying exposure to these pollutants is problematic. Objective. Our goal was to explore the utility of kriging, a spatial interpolation method, for exposure assessment in epidemiologic studies of HAPs. We used benzene as an example and compared census tract-level kriged predictions to estimates obtained from the 1999 U.S. EPA National Air Toxics Assessment (NATA), Assessment System for Population Exposure Nationwide (ASPEN) model. Methods. Kriged predictions were generated for 649 census tracts in Harris County, Texas using estimates of annual benzene …