Public Health Commons^™

Predictors Of Intense End-Of-Life Care Among Children And Young Adults With Advanced Hematologic Malignancies, Sophia Mun

Public Health Theses

Background: Studies suggest that children, adolescents, and young adults (AYAs) with advanced cancer receive intense end-of-life (EOL) care. This is particularly true for patients with hematologic malignancies. Yet, it is unclear who is at highest risk for receiving intense care.

Methods: We used the Premier Healthcare Database to perform a population-based analysis of patients aged 0-39 years at death with hematologic malignancies who died between 2010-2017. We defined intense EOL care as: receipt of cardiopulmonary resuscitation (CPR), intubation, hemodialysis, or tracheostomy within the last 30 days of life; more than one emergency room (ER) visit within the last 30 days …

Assessing The Effect Of The Fto (Rs9939609) Gene On Weight Loss Among Breast Cancer Survivors Enrolled In The Lifestyle, Exercise, And Nutrition (Lean) Study, Hien Thai Nguyen

Public Health Theses

Abstract: Background: A single nucleotide polymorphism (SNP) of the Fat, Mass, and Obesity associated (FTO) gene, rs9939609, is significantly associated with obesity and individual variability in weight loss achieved by diet/lifestyle interventions. However, study results on the effect of the FTO gene on weight loss remains inconsistent. This study aims to examine the moderating effects of the FTO SNP rs9939609 on weight loss achieved by a lifestyle intervention in breast cancer survivors. Methods: Breast cancer survivors with a body mass index (BMI) > 25 kg/m2 were randomized to the LEAN 6-month intervention, which included eleven 30-min counseling sessions focused on reducing …

Randomized Trial Of Weight Loss On Ghrelin Levels Among Breast Cancer Survivors, Leah Puklin

Public Health Theses

Purpose: Obesity is associated with increased breast cancer risk and mortality. Ghrelin is a hormone that participates in a negative feedback loop to regulate body weight. Understanding the impact of an individualized, sustainable, dietary and exercise weight-loss intervention on circulating ghrelin levels could provide insight on weight control mechanisms among overweight and obese breast cancer survivors.

Methods: The Lifestyle, Exercise, and Nutrition (LEAN) randomized controlled trial was a 6-month weight loss trial conducted to examine the effect of a weight loss intervention versus usual care on outcomes in 151 breast cancer survivors with BMI ≥ 25 kg/m2. Fasting blood samples …

Associations Between Mindful Eating Techniques And Gestational Weight Gain, Yuqing Shang

Public Health Theses

Abstract

Objective: To investigate the extent to which the use of mindful eating techniques is associated with gestational weight gain among a clinic-based sample of pregnant women.

Methods: Four hundred and forty-eight pregnant women in their second trimester of pregnancy participated in the Expect With Me group care study and were selected for this secondary analysis. Sociodemographic and general health data was collected at baseline. Mindfulness practice was measured based on frequency of performing mindful thinking and mindful eating techniques in the third trimester. The main outcome was excessive average weekly gestational weight gain, which was determined using the guidelines …

Evaluation Of Sociodemographic Factors And Presence Of Oil And Gas Waste Disposal Wells In Kansas, Katherine Rose Wolf

Public Health Theses

Background and objective: Kansas hosts the second-largest number of wells in the United States for the disposal of oil and gas waste (n = 13,396), which can contain chemicals toxic to human health. In this study we evaluate potential associations between oil and gas waste disposal well locations and sociodemographic characteristics in Kansas.

Methods: We obtained oil and gas production and disposal well data from the Kansas Geological Survey and sociodemographic data at the census block group level from the United States 2013–2017 American Community Survey. We used two-variable t-tests, logistic regression with and without thin plate spatial splines, and …

Evaluating Clostridioides Difficile Infection (Cdi) Risk Factors By Comparing The Use Of Piperacillin/Tazobactam, Cefepime, And Ceftazidime, Shardul Rathod

Public Health Theses

Introduction: Over the past several years, Clostridioides difficile infection (CDI) incidence has been rising. The primary risk factor for CDI is antibiotic use. Many studies indicate that penicillin drugs are among the low-risk antibiotic classes associated with CDI whereas cephalosporin drugs are among the high-risk antibiotic classes. However, there is variation in studies evaluating the healthcare-associated CDI (HA-CDI) risk associated with antibiotics within a class and limited data comparing the use of penicillin versus cephalosporin drugs.

Methods: An observational cohort study was performed using patient data from BH and YNHH. Minitab (Version 18) was used to perform survival analysis and …

Analysis Of Entomological Surveillance Data To Predict West Nile Virus Cases In Connecticut, Lena Marie Tayo

Public Health Theses

INTRODUCTION: Since 1999, West Nile Virus (WNV) has been identified in a wide variety of mosquito species. Seasonal epidemics occur in the summer in all regions of the United States, with varying degrees of intensity and spread. In Connecticut, the state mosquito surveillance system for WNV has been conducted since 2000, collecting entomological and site data, and acting as an early warning system for potential human disease risk.

AIMS: Re-analysis of the epidemiology of WNV in Connecticut after years of established endemicity will be conducted using recent mosquito surveillance and human case data. A predictive model will also be developed …

Nut And Peanut Butter Consumption And Risk Of Prostate Cancer In The Nih-Aarp Diet And Health Study, Mimi (Trucmai) Nu Ton

Public Health Theses

Background: While nuts and their related nutrients have been inversely associated with some cancers, the association between nut consumption and prostate cancer has been inconsistent.

Methods: We conducted an analysis of the association between nut and peanut butter consumption and risk of incident prostate cancer among 173,243 men in the prospective NIH-AARP Diet and Health Study. There was a total of 18,619 incident prostate cancer cases during the 16 years of follow-up. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression for intake of nuts, peanut butter, and total nuts (nuts plus peanut butter), …

Average Time To Negativity Of New Alere Ultra-Sensitive Rapid Diagnostic Test After Treatment For Malaria., Azan Zahir Virji

Public Health Theses

Malaria remains one of the most challenging infections globally. Malaria RDTs have had the largest impact on malaria detection in recent years with almost 245 million RDTs delivered globally. (1) They work by detecting either the histidine-rich protein (HRP2) or the Plasmodium lactate-dehydrogenase (pLDH). (2) Following a malaria infection, the HRP2 and pLDH antigens often circulate in the blood stream for several weeks. (3) As new RDTs are constantly being developed, each with a better sensitivity, specificity and lower limit of detection than its predecessor, the need to understand the persistence of their positivity, following a malaria infection, remains. The …

State Vaccination Policies And Coverage For Adolescent Vaccines In The United States, 2017, Anthony Edward Yakely

Public Health Theses

Background: The wide-ranging nature of state vaccination requirements for school entry allows for suboptimal coverage of adolescent vaccination as well as missed opportunities where some adolescent vaccinations are received but not all of them. Variation exists both in the types of exemptions that are allowed and the process that is required to obtain an exemption. State-level policies have been shown to be associated with childhood vaccination coverage, but far fewer studies have examined adolescent vaccine coverage.

Methods: HPV, MenACWY, and Tdap vaccine receipt and demographic data from the 2017 National Immunization Survey-Teen (NIS-Teen) Public Use Dataset were combined with data …

Differential Effects Of Medicaid Expansion On Racial/Ethnic Disparities In Primary Care Access, Janet Yim

Public Health Theses

By providing health insurance to low-income and disabled children and adults, the United States’ Medicaid program increases health care access and utilization by those with limited access to affordable private insurance. To increase coverage, the Affordable Care Act (ACA) helped fund state expansions of Medicaid’s eligibility criteria to include low-income adults with incomes up to 138% of the Federal Poverty level. This paper examines the differential effects of Medicaid expansion on racial/ethnic disparities in primary care access using a quasi-experimental differences-in-differences design. Regression analyses consider low income adults (defined as below 138% FPL) ages 19-64. When analyzing both short term …

Prion Epidemiology And The Npdpsc’S Experience With Rt-Quic, Aleksandra Wrona

Public Health Theses

Prion diseases, or transmissible spongiform encephalopathies, constitute a wide array of invariably fatal rapidly progressive neurodegenerative illnesses that affect both humans and animals. The gold standard of diagnosis for these diseases is through neuropathologic examination of brain tissue following autopsy. In September 2018, the Centers for Disease Control and Prevention (CDC) added positive real-time quaking-induced conversion (RT-QuIC) test result as a likely indicator of certain human prion diseases. With high sensitivity and specificity approaching 100%, RT-QuIC has quickly become one of the most powerful antemortem diagnostic tools.

This paper will demonstrate why changes in diagnostic criteria and reporting metrics are …

Epigenetic Silencing Rna Methylation Machinery Fto And Mettl3 Associate With Patient Survival In Renal Clear Cell Carcinoma, Jiaxun Zhao

Public Health Theses

Purpose: RNA methylation eraser FTO and writer METTL3 play important roles in human diseases by regulating gene expression. However, the potential of FTO and METTL3 as markers in renal clear cell carcinoma (CCRCC) is still unknown. The purpose of this study is to investigate differential expression of FTO and METTL3 in CCRCC vs. normal kidney tissues, the association of FTO and METTL3 expression and methylation with and their interaction of FTO and METTL3 expression in patient survival in CCRCC.

Method: FTO and METTL3 expression and methylation, the clinicopathologic data were retrieved from a publicly accessed dataset of The Cancer Genome …

A Comprehensive Evaluation Of Breast Cancer Risk Prediction Using Uk Biobank Data., Xiaorui Zhu

Public Health Theses

Introduction: Both genetic and clinical risk factors play roles in breast cancer onset. Developing comprehensive and accurate breast cancer prediction model will enable effective identifications of individuals at high risk, and facilitate personalized decision on screening and preventive strategy.

Objectives: Develop a risk prediction model for breast cancer including both genetic and clinical risk factors, and quantify the benefit of adding polygenic risk score (PRS) in risk prediction.

Methods: Analysis was based on data collected through the UK Biobank which consist of 13,851 breast cancer cases and 206,865 controls. The clinical factors that we considered include baseline demographics, lifestyles, family …

Using Volatile Organic Compounds In Exhaled Breath As A Biomarker For Early Lung Cancer Detection: A Systematic Review, Jieqiong Zhou

Public Health Theses

Lung cancer has become the most commonly diagnosed cancer and the leading cause of cancer deaths globally. The major problem of the high mortality rate is the late diagnosis. Conventional methods utilized for clinical detection of lung cancer have employed expensive and invasive medical procedures that cause stress, discomfort, and pain to patients, and have demonstrated low sensitivity, substantial false negatives, and risk of radiation exposure. The drawbacks obviate their applicability to large-scale, population-wide screening efforts. This paper reviews the applications of using volatile organic compounds (VOCs) in exhaled breath as a potential approach for early lung cancer detection.

An …

Coarse Particulate Matter Exposure And Inflammation, Emilie Elizabeth Davis

Public Health Theses

Background Cardiovascular disease (CVD) is the leading cause of death in the United States, and environmental exposures, such as air pollution, contribute to the risk of CVD. While previous studies have found that fine particles, PM 2.5, are associated with CVD risk, fewer studies have considered the effect of coarse particles, PM 10-2.5, on CVD risk and the possible biological mechanism through which this environmental exposure could increase CVD risk. Methods This analysis examines the association between ambient concentrations of PM 10-2.5 and a marker of CVD risk in a cohort of midlife women. Annual questionnaire and clinical data were …

Wellness Policy Awareness Among School Leaders And The Impact On Written Policy Scores, Mariah Reil

Electronic Theses and Dissertations

Background: All schools participating in the National School Lunch Program must possess a written School Wellness Policy (SWP) as mandated by the Healthy, Hunger- Free Kids Act of 2010.1 School officials and leaders play a major role in SWP implementation. It is essential to written SWP implementation that school level officials and leaders in the district are aware of the SWP. However, the association between school leader awareness of SWP and policy quality has not yet been studied.
Purpose: The purpose of the present study was to determine if school leader awareness of a SWP impacts the written SWP quality. …

Embodied Control: Biopolitics In The Water Crisis Of Flint, Mi And Appalachian Coal, Sarah Wheeler

Occam's Razor

Flint, Michigan still doesn't have clean water or safe pipes. On the border between West Virginia and Pennsylvania, a coal ash pond called Little Blue Run has been leaking toxic metals into nearby streams for four decades (Patterson, 2018). While these two regions differ in their location and history, similarities can be contextualized and understood based on class, race, state sanctioned water contamination, the exploitation of natural resources, and environmental crimes. Given the factors at work when water crises occur, it is crucial to recognize the United States' practice of knowingly poisoning their citizens, to draw parallels between the practice …

The Evidence Of Human Exposure To Glyphosate: A Review, C. Gillezeau, M. Van Gerwen, R. M. Shaffer, I. Rana, L. Zhang, L. Sheppard, E. Taioli

Journal Articles

© 2019 The Author(s). Background: Despite the growing and widespread use of glyphosate, a broad-spectrum herbicide and desiccant, very few studies have evaluated the extent and amount of human exposure. Objective: We review documented levels of human exposure among workers in occupational settings and the general population. Methods: We conducted a review of scientific publications on glyphosate levels in humans; 19 studies were identified, of which five investigated occupational exposure to glyphosate, 11 documented the exposure in general populations, and three reported on both. Results: Eight studies reported urinary levels in 423 occupationally and para-occupationally exposed subjects; 14 studies reported …

Outcomes Of Pulmonary Resection In Non-Small Cell Lung Cancer Patients Older Than 70 Years Old, A. Tantraworasin, S. Siwachat, N. Tanatip, N. Lertprasertsuke, S. Kongkarnka, J. Euathrongchit, Y. Wannasopha, T. Suksombooncharoen, E. Taioli, S. Saeteng, +1 Additional Author

Journal Articles

© 2019 Background: An appropriate treatment of older lung cancer patients has become an important issue. The aim of this study is to evaluate the short and long-term surgical outcomes in lung cancer patients using 70 years as a cut-point, and to identify prognostic factors of cancer-specific mortality in patients older than 70 years. Methods: Medical records of non-small cell lung cancer (NSCLC) patients who underwent pulmonary resection at Chiang Mai University Hospital from January 2002 through December 2016 were retrospectively reviewed. Patients were divided into age less than 70 years (control group) and 70 years or more (study group). …