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Population-Level Determinants Of Cholera Incidence In African Countries, Ngoy Nsenga

Walden Dissertations and Doctoral Studies

Cholera remains endemic in Africa, with limited access to safe drinking water and inadequate sanitation as 2 of the main drivers of its dissemination. Few studies have examined the impact of health system capacity, even though it plays an important role in prevention, early detection, and response to a cholera outbreak. Grounded in the ecosocial theory of infectious disease dissemination, this quantitative ecological study explored the effect of social vulnerability (as measured by access to safe drinking water and sanitation, rate of open defecation, poverty, income inequality, gender inequality, and adult literacy) and health system (as measured by health financing …

Demographic, Environmental, And Clinical Variables Associated With Dengue In Saint Lucia, Brendan Lee

Walden Dissertations and Doctoral Studies

Dengue is the most important arboviral disease of public health concern on the world stage. In Saint Lucia, the disease has been endemic for years. Little research has been published on the specific epidemiology of dengue in Saint Lucia, and this study sought to identify the risk factors associated with the disease specific to the island. This study was underpinned by ecological theory, which is used to explain the possible relationships between risk factors and the occurrence of dengue. This three-manuscript study was used to evaluate the relationship between demographic, environmental, and clinical variables and the occurrence of dengue as …

Population Density And Spatial Distribution Of Neglected Tropical Diseases In Sierra Leone, Abou B. Funna

Walden Dissertations and Doctoral Studies

Neglected tropical diseases (NTDs) are the most common health conditions affecting the poorest residents of sub-Saharan Africa (SSA). These infections affect an estimated 2 billion people worldwide, including 500 million people living in SSA. About 85% of NTD infections are a result of helminth infections; hookworm is also a common occurrence among SSA’s poorest people, especially children. Schistosomiasis is the 2nd most prevalent NTD after hookworm. This quantitative correlational study investigated population distribution and the spread of NTDs in Sierra Leone. The focus was on 5 major NTDs: ascariasis, hookworm, schistosomiasis, soil-transmitted helminthiasis, and trichuris. Data were obtained from the …

Socioeconomic Status, Benzathine Penicillin Prophylaxis, And Clinical Outcomes In Patients With Rheumatic Heart Disease, Christopher Sabo Yilgwan

Walden Dissertations and Doctoral Studies

Rheumatic heart disease (RHD) is the major cause of acquired heart disease and death for children and young adults in developing countries. Poverty and social disadvantage are thought to influence the clinical outcomes in RHD patients. Guided by the health lifestyle theory, this study assessed the relationship between socioeconomic status and clinical outcomes (heart failure events and mortality) in patients with RHD. It also examined how adherence to penicillin prophylaxis mediates the effect of socioeconomic status (SES) on clinical outcomes. Using the Nigerian database of the REMEDY study, this study was conducted with 243 participants using Poisson regression and logistic …

The Association Between Melanoma And Exposure To Arsenic Among U.S. Adults Using The National Health And Nutrition Examination Survey (Nhanes) From 2003 To 2016, Ahmed Bedaiwi

Capstone Experience: Master of Public Health

Background: Melanoma is a deadly skin cancer at late stages, and its incidence has been increasing significantly over the last ten years in the United States. Chronic exposure to arsenic has been associated in many studies as a risk factor for non-melanoma skin cancer, notably squamous cell carcinoma. However, current knowledge is limited regarding melanoma and long-term arsenic exposure.

Methods: We conducted a cross-sectional study using the 2003-2016 cycles of the National Health and Nutrition Examination Survey (NHANES), to investigate the association between arsenic exposure and self-reported melanoma and non-melanoma skin cancer diagnoses. Univariate and multivariate logistic regressions were conducted. …

Is There Less Opioid Abuse In States Where Marijuana Has Been Decriminalized, Either For Medicinal Or Recreational Use? A Clin-Iq, Aaron M. Wendelboe, Richard Mathew, Tana Chongsuwat, Elizabeth Rainwater, Mark A. Wendelboe, Elizabeth Wickersham Md, Ann F. Chou

Journal of Patient-Centered Research and Reviews

Opioid use, abuse, and associated mortality have reached an epidemic level. In some states, cannabis is being used to treat chronic pain. To examine the hypothesis that medical marijuana legislation may reduce adverse opioid-related outcomes if patients substitute cannabis for opioids for pain management, we conducted a clinical inquiry (Clin-IQ). We searched Ovid MEDLINE, Ovid MEDLINE In-Process, and Embase for studies using the search terms marijuana, cannabis, legal, marijuana smoking, medical marijuana, opioid-related disorders, cannabis use, medical cannabis, legal aspect, and opiate addiction. We included population-based articles published from January 1, 2012, through December 5, 2018, that assessed the relationship …

Evolutionary Dynamics Of Influenza Type B In The Presence Of Vaccination: An Ecological Study, Lindsey J. Fiedler

USF Tampa Graduate Theses and Dissertations

Understanding the evolutionary dynamics of influenza type B in human hosts is a public health concern as we strive to minimize the disease burden in seasonal epidemics. Vaccination is considered the best defense against contracting influenza, and everyone over the age of 6 months is advised to get vaccinated before each season. The effect that vaccine-acquired immunity has on the evolution of influenza B remains unclear. In the U.S., vaccine-uptake is irregular across the states, and the differing coverages present an opportunity to study how vaccination influences viral evolution. This thesis analyzes the evolutionary patterns of influenza B in the …

Alcohol Sale Status And Homicide Victimization In Kentucky, 2005-2012: Is There A Spatial Association?, Hanan Abdulghafoor Khaleel, Sabrina Brown, Steven T. Fleming, W. Jay Christian

Epidemiology and Environmental Health Faculty Publications

To date, the association between the alcohol sale status of decedents’ residence and alcohol-related homicide victimization have not been studied as far as we know. The current study aims to: i) determine whether homicide victims who were residents of wet counties had higher odds of testing positive for alcohol than their counterparts in moist or dry counties after adjusting for confounders; ii) determine whether homicides and alcohol-related homicides tend to cluster spatially; iii) determine whether the aforementioned associations exist only in highly-populated counties. A multilevel logistic regression analysis was used to analyze the data on homicide victims in the Kentucky …

Respiratory Infections And Risk For Development Of Narcolepsy: Analysis Of The Truven Health Marketscan Database (2008 To 2010) With Additional Assessment Of Incidence And Prevalence, Darren Scheer

USF Tampa Graduate Theses and Dissertations

Background and Significance: Narcolepsy is a chronic neurological disorder. These patients experience various psychiatric and physical comorbid diseases and mortality at an increased rate compared to the general population. Additionally, patients with narcolepsy experience approximately a doubling of various annual healthcare related facility visits, transactions, and costs comparatively. Narcolepsy with cataplexy is generally believed to be more prevalent than narcolepsy without cataplexy. However, incidence and prevalence estimates of narcolepsy (with or without cataplexy) vary widely with few large epidemiological studies conducted worldwide and none in the U.S evaluating these proportions in both children and adults utilizing a large health care …

Descriptive And Risk Factor Analysis Of Infantile Cataracts, Marine Nalbandyan

Legacy Theses & Dissertations (2009 - 2024)

Infantile cataract is a lens opacity diagnosed by 12 months of age. It is a major cause of childhood blindness, with about 200,000 children worldwide being blind because of bilateral cataracts. Blindness has a negative impact on the quality of a child’s life and is associated with increased healthcare costs. While reduction/elimination of childhood blindness is a priority issue in public health, risk factors remain unknown for about two-thirds of infantile cataract cases. The primary aims of this dissertation were to (1) identify, evaluate, and summarize observational studies investigating non-genetic risk factors for infantile cataracts, (2) estimate birth prevalence and …

Evaluation By Geospatial And Spatiotemporal Distribution Of Tularemia Cases In Arkansas, Toni Kathleen Beavers

Walden Dissertations and Doctoral Studies

Tularemia is a vector-borne disease of global concern with diverse regional foci. Arkansas is an endemic state with differences in case distribution and land suitability supporting host and vector sustainment. The aim of this study was to conduct a geospatial and spatiotemporal assessment of factors associated with case distribution and timeliness and completeness of public reporting. Guided with direction from spatial epidemiology and nidality, referring to the association of ecology, climate, and proximity of disease, analysis included secondary data collected from the Arkansas Department of Health between 1995 and 2018. Using Poisson-based software, 2 clusters were found: a high-risk cluster …

Hazardous Waste Site Proximity And Type 2 Diabetes: From Youths To Adults, Theresa Ann Johnson

Walden Dissertations and Doctoral Studies

Type 2 diabetes has reached epidemic proportions in adults and youths. Persistent organic pollutants and endocrine-disrupting chemicals (EDCs), such as pesticides, dioxins, and organochlorines, are omnipresent and persist in the environment with potential for human exposure via contaminated air, waterways, soil, and human food supply. EDCs have been correlated with diabetes incidence and risks. Residential proximity to hazardous waste sites (HWS) has been correlated with increased hospital admission rates for diabetes. The study used a sample population (N = 1,724), ages ≥ 12 years from the 2005-2012 Continuous NHANES and HWS data from the National Priorities List of Superfund Sites. …

Lead And Crime: An Ecological Study Between Lead Contaminated Topsoil And Violent Crime., Brian Guinn

Electronic Theses and Dissertations

Lead is a known neurotoxicant. Human exposure to lead comes primarily through environmental exposures, including remnant lead paint, lead contaminated topsoil and lead contaminated water. Prenatal and early life lead exposure has been associated with numerous neurocognitive and neuropsychiatric disorders. This dissertation presents findings from an ecological study which evaluated the geospatial association between topsoil lead content and the incidence of FBI designated violent crime in Jefferson County, Kentucky. A total of 412 topsoil samples were collected along roadways (n=300) and from Louisville Metro Parks (n=112). Jefferson County crime data was obtained from the Louisville Metro Police Department – Crime …

Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, The Clinical Research Coordinating Center Team

The University of Louisville Journal of Respiratory Infections

Insufficient infrastructure is one of the challenges facing investigators in the field of clinical research. At the University of Louisville (UofL) Division of Infectious Diseases, we developed a multidisciplinary coordinating center with the aim to support investigators in all aspects of the clinical research process. The objective of this article is to describe the composition and the role of the different units of the UofL Clinical Research Coordinating Center. The different components of the Center can serve as a template for institutions interested in developing a clinical research support infrastructure.

Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, Andrea Reyes-Vega

Faculty and Staff Scholarship

Insufficient infrastructure is one of the challenges facing investigators in the field of clinical research. At the University of Louisville (UofL) Division of Infectious Diseases, we developed a multidisciplinary coordinating center with the aim to support investigators in all aspects of the clinical research process. The objective of this article is to describe the composition and the role of the different units of the UofL Clinical Research Coordinating Center. The different components of the Center can serve as a template for institutions interested in developing a clinical research support infrastructure.

Race And “Hotspots” Of Preventable Hospitalizations, Caryn N. Bell, Janice V. Bowie, Roland J. Thorpe Jr.

Journal of Health Disparities Research and Practice

Abstract

Preventable hospitalizations (PHs) are those for ambulatory care-sensitive conditions that indicate insufficiencies in local primary healthcare. PH rates tend to be higher among African Americans, in urban centers, rural areas and areas with more African American residents. The objective of this study is to determine geographic clusters of high PH rates (“spatial clusters”) by race. Data from Maryland hospitals were utilized to determine the rates of PHs in zip code tabulation areas (ZCTAs) by race in 2010. Geographic clusters of ZCTAs with higher than expected PH rates were identified using Scan Statistic and Anselin’s Local Moran’s I. 10 PH …

Liver Cancer Disparities In New York City: A Neighborhood View Of Risk And Harm Reduction Factors, G. R. Kamath, E. Taioli, N. N. Egorova, J. M. Llovet, P. V. Perumalswami, J. J. Weiss, M. Schwartz, S. Ewala, N. A. Bickell

Journal Articles

© 2018 Kamath, Taioli, Egorova, Llovet, Perumalswami, Weiss, Schwartz, Ewala and Bickell. Introduction: Liver cancer is the fastest increasing cancer in the United States and is one of the leading causes of cancer-related death in New York City (NYC), with wide disparities among neighborhoods. The purpose of this cross-sectional study was to describe liver cancer incidence by neighborhood and examine its association with risk factors. This information can inform preventive and treatment interventions. Materials and methods: Publicly available data were collected on adult NYC residents (n = 6,407,022). Age-adjusted data on liver and intrahepatic bile duct cancer came from the …

An Epidemiological Study Of Invasive Pneumococcal Disease In A South Texas-Mexico Border Metropolitan Community, Steven Daniel Hinojosa

Graduate Research Theses & Dissertations

This research study examines the epidemiology of invasive pneumococcal disease in Hidalgo County, Texas. Invasive pneumococcal disease is a bacterial infection, causing severe types of clinical manifestations, including bacteremia and meningitis. Hidalgo County is the largest metropolitan statistical area along the Texas-Mexico border. Supporting a 2016 census population estimate of nearly 850,000, this community facilitates frequent bi-national travel, providing unique attributes towards disease transmission. This study aims to identify if population characteristics for infection aligned with current Advisory Committee for Immunization Practice recommendations for vaccination against pneumococcal disease. This includes identifying if the general healthy adult healthy population has an …

Environmental Exposure To Atrazine And Birth Defects: An Ecological Study In Kentucky, 2005-2014, Maria Dimitrios Politis

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Atrazine is one of the most widely used pesticides in the United States. Studies have shown that pesticides, in particular herbicides such as atrazine, may be associated with birth defects. The purpose of this study is to evaluate the association between potential environmental exposures to atrazine in water systems and prevalence rates of birth defects for the state of Kentucky. An ecological study using the Kentucky Birth Defects Registry Surveillance and the Kentucky Geological Survey databases from 2005 to 2014 was conducted. Poisson regression was used to estimate crude and adjusted rate ratios of the association between agricultural exposure metrics …

Using Prescription Drug Monitoring Data To Inform Population Level Analysis Of Opioid Analgesic Utilization, Huong T. T. Luu

Theses and Dissertations--Epidemiology and Biostatistics

Increased opioid analgesic (OA) prescribing has been associated with increased risk of prescription opioid diversion, misuse, and abuse. States established prescription drug monitoring programs (PDMPs) to collect and analyze electronic records for dispensed controlled substances to reduce prescription drug abuse and diversion. PDMP data can be used by prescribers for tracking patient’s history of controlled substance prescribing to inform clinical decisions.

The studies in this dissertation are focused on the less utilized potential of the PDMP data to enhance public health surveillance to monitor OA prescribing and co-prescribing and association with opioid overdose mortality and morbidity. Longitudinal analysis of OA …

How Fine Particulate Matter Modifies Preterm Birth Risks In Korea, Hyun Jin Choi

Walden Dissertations and Doctoral Studies

Despite the increasing interest in preterm birth risk associated with maternal exposure to the current level of fine particulate matter (PM2.5) in Korea, there is little information on differences in PM2.5 exposure and its impact on preterm birth. This study was designed to examine the effects of Korea's air quality on preterm birth, including the possibility of moderation and mediation. This work was also designed to investigate manipulable factors for PM2.5 exposure. The theoretical framework of this quantitative and observational study included the social ecological theory and systems theory. The conceptual framework of this partially ecologic and retrospective cohort study …

Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner

Walden Dissertations and Doctoral Studies

Insulin resistance is an increasing public health issue with the current literature, suggesting reduced sensitivity of insulin leads to adult onset diabetes and associated downstream pathologies that reduce life expectancy. The main objectives of this study were to evaluate the ability of the Oral Glucose Insulin Secretion Test (OGIST) to identify insulin resistance and examine differences in the insulin sensitivity based on gender, age, and ethnicity. This study was supported by the insulin resistance theory which focuses on the reduced ability of insulin to bind to the cellular insulin receptor, reducing the sensitivity of insulin. The OGIST lab results of …

Moving Mountains : A Study Examining Long-Term Impacts Of Mountaintop Removal Coal Mining On Mortality In The Appalachian Region Using Geographic Information Sciences Techniques., James Howard Kent Pugh

Electronic Theses and Dissertations

Over the last hundred years, the Appalachian region has been dominated by the coal industry. It has also been and currently is one of the unhealthiest regions in the United States. Recent scholarship has examined the relationship between coal mining and health and mortality rates in the Appalachian region. The first study incorporates air quality and pollution data to examine if coal mining counties have higher levels of pollution and if this pollution contributes to mortality disadvantage. In the second study, I construct a population-based coal-exposure measure to better evaluate the relationship between coal mining and health I find that …

Sleep And Alzheimer’S Disease: A Critical Examination Of The Risk That Sleep Problems Or Disorders Particularly Obstructive Sleep Apnea Pose Towards Developing Alzheimer’S Disease, Omonigho A. Michael Bubu

USF Tampa Graduate Theses and Dissertations

This dissertation is a critical examination of the relationship between sleep problems and/or disorders, particularly Obstructive Sleep Apnea (OSA) and Alzheimer Disease (AD). First, I conducted an exhaustive systematic review of existing literature, and identified gaps in research that led to specific research aims. For the first aim, I conducted the first ever-published meta-analysis examining sleep, cognitive decline and AD, providing an aggregate effect of sleep on AD. Second, focusing on OSA, I conducted a study examining OSA’s effect on longitudinal changes on AD biomarkers in cognitive normal, MCI and AD subjects, using data from the Alzheimer Disease Neuroimaging Initiative …

Socioeconomic Status, Air Quality And Geographic Variation In Emergency Room Visits For Acute Bronchitis On The California Central Coast, Sean Lang-Brown, Heather W. Starnes, Gary B. Hughes

Symposium

IMPORTANCE: Analysis of geospatial variation in acute bronchitis due to socioeconomic and environmental factors can allow the efficient delivery of resources to populations most at risk.

OBJECTIVE: We sought to determine if small scale variation in socioeconomic factors and emergency room (ER) visits for acute bronchitis are associated in small cities or rural communities. We also modeled the effects of air quality on daily rates of ER visits for acute bronchitis in the context of socioeconomic factors to investigate modifying relationships.

DESIGN, SETTING, AND PARTICIPANTS: We examined ER visits for acute bronchitis in San Luis Obispo and Santa Barbara counties …

Incorporating Place And Space: A Hierarchical Spatial Approach To Exploring Preventable Congestive Heart Failure Hospitalizations In New York City, Rachael Weiss Riley

Dissertations and Theses

Background: Faced with rising medical care costs, increasing prevalence, and widening health disparities, preventing congestive heart failure (CHF) hospitalizations is a central public health concern. Despite evidence of geographical clustering in preventable CHF admissions, there is a lack of research designed to examine spatial patterning of CHF and the local area neighborhood determinants that contribute to this variability. This study sought to assess and evaluate the importance of both space and place in analyzing preventable CHF hospitalizations and readmissions by applying appropriate statistical techniques, clarifying the assumption inherent in each method, and interpreting the findings within the context of existing …

Ebola Virus - Epidemiology, Diagnosis, And Control: Threat To Humans, Lessons Learnt, And Preparedness Plans - An Update On Its 40 Year's Journey, Raj Kumar Singh, Kuldeep Dhama, Yashpal Singh Malik, Muthannan Andavar Ramakrishnan, Kumaragurubaran Karthik, Rekha Khandia, Ruchi Tiwari, Ashok Munjal, Mani Saminathan, Perumal Arumugam, Sunil Kumar Joshi

Bioelectrics Publications

Ebola virus (EBOV) is an extremely contagious pathogen and causes lethal hemorrhagic fever disease in man and animals. The recently occurred Ebola virus disease (EVD) outbreaks in the West African countries have categorized it as an international health concern. For the virus maintenance and transmission, the non-human primates and reservoir hosts like fruit bats have played a vital role. For curbing the disease timely, we need effective therapeutics/prophylactics, however, in the absence of any approved vaccine, timely diagnosis and monitoring of EBOV remains of utmost importance. The technologically advanced vaccines like a viral-vectored vaccine, DNA vaccine and virus-like particles are …

Early Diagnosis And Intervention For Young Children With Autism Spectrum Disorder In New York State, Grace Ester Caroline Korompis

Health Policy, Management & Behavior Theses & Dissertations

This study examined the prevalence of autism spectrum disorder (ASD), analyzed the trends, assessed children’s sociodemographic characteristics and examined timing of ASD diagnosis among children who enrolled in the New York State Early Intervention Program (NYSEIP).

Secondary data from the New York State Early Intervention data systems were used. The systems include NYEIS (New York State Early Intervention System), a centralized web-based system that electronically manages the NYSEIP administrative tasks and was designed to support the NYSEIP's services, and the legacy data system: KIDS (Kids Integrated Data System). The time-trend design employed in this study was a form of longitudinal …

Impact Of Foreign Born East Asian Density On Liver Cancer Incidence Rate Among Neighborhoods In New York City During 2009-2013 : Multilevel Analysis, Sangwon Lee

Legacy Theses & Dissertations (2009 - 2024)

Objective: To investigate the impact of the density of foreign born Asian population on geographical incidence rate of liver cancer in New York City during 2009 – 2013 in order to find specific geographic areas in NYC where liver cancer intervention should be targeted.

Early Diagnosis And Intervention For Young Children With Autism Spectrum Disorder In New York State, Grace Esther Caroline Korompis

Legacy Theses & Dissertations (2009 - 2024)

This study examined the prevalence of autism spectrum disorder (ASD), analyzed the trends, assessed children’s sociodemographic characteristics and examined timing of ASD diagnosis among children who enrolled in the New York State Early Intervention Program (NYSEIP).