Medicine and Health Sciences Commons^™

Geographic Disparities Associated With Stroke And Myocardial Infarction In East Tennessee, Ashley Pedigo Golden

Doctoral Dissertations

Stroke and myocardial infarction (MI) are serious conditions whose burdens vary by socio-demographic and geographic factors. Although several studies have investigated and identified disparities in burdens of these conditions at the county and state levels, little is known regarding their geographic epidemiology at the neighborhood level. Both conditions require emergency treatments and therefore timely geographic accessibility to appropriate care is critical. Investigation of disparities in geographic accessibility to stroke and MI care and the role of Emergency Medical Services (EMS) in reducing treatment delays are vital in improving health outcomes. Therefore, the objectives of this work were to: (i) classify …

Spatio-Temporal Modeling Of Arthropod-Borne Zoonotic Diseases: A Proposed Methodology To Enhance Macro-Scale Analyses, Stephen Jones

All Dissertations

Zoonotic diseases are infectious diseases that can be transmitted from or through animals to humans, and arthropods often act as vectors for transmission. Emerging infectious diseases have been increasing both in prevalence and geographic range at alarming rates the last 30 years, and the majority of these diseases are zoonotic in nature. Many zoonotic diseases are considered notifiable by the Centers for Disease Control and Prevention (CDC). However, though state regulations or contractual obligations may require the reporting of certain diseases, significant underreporting is known to exist. Because of the rich volume of information captured in health insurance plan databases, …

Spatial Distribution Of Obesity Among West Virginia 5th Grade Children: Analysis Of The Socioeconomic, Physical, And Personal Environment, Sherry Roper

Theses and Dissertations (ETD)

Childhood obesity defined as a body mass index (BMI) at or above the 95th percentile for children of the same age and sex, is considered an epidemic in the United States. Biology and lifestyle behaviors have been identified as important factors in the development of childhood obesity; however, researchers are beginning to place more emphasis upon the impact that continual environmental exposures have upon obesity development. Environmental risk factors associated with obesity are distributed continuously over space, yet evidence suggests that burden of risk may not be evenly dispersed across a community. West Virginia (WV), a rural Appalachian community has …

Analysis Of The Morbidity And Mortality Of Severe Influenza Infection In Clark County, Nevada For The 2010--2011 Influenza Season, Kindra Maureen St. Jacques

UNLV Theses, Dissertations, Professional Papers, and Capstones

Influenza circulates in the community in a fairly predictable manner each year; however, throughout the duration of any influenza season, influenza strains have the ability to evolve through antigenic mutations, viral reassortment, development of anti-viral resistance, and alterations in virulence. These changes are likely to cause illness among the unimmunized and can result in severe illness or death. Therefore, it is especially important to closely monitor severe influenza-associated hospitalizations and deaths. The University of Nevada, Las Vegas in collaboration with the Southern Nevada Health District (SNHD), Office of Epidemiology (OOE) analyzed data from the severe hospitalized influenza morbidity and mortality …

Evaluation Of The Pilot Program, Pediatric Early Warning Sentinel Surveillance Program (Pewss), And Its Efficacy In Monitoring Pediatric Illness In Clark County, Nevada, Michelle Lee Lutman

UNLV Theses, Dissertations, Professional Papers, and Capstones

The influenza outbreak that occurred during 2009 stimulated the formation of several surveillance programs throughout the country. The majority monitor only influenza; however, there are several other circulating respiratory pathogens, especially within the pediatric community. These other respiratory pathogens cause a variety of illnesses, such as bronchitis, pneumonia, croup, etc. Prior research has provided the medical community with valuable information about respiratory illnesses, especially those which afflict pediatric patients. Areas of knowledge including seasonality, demographics, signs and symptoms, prevention measures, and pathogenicity, have been greatly expanded over the years. This information has been of tremendous help to the medical community …

A Comparative Study Of Indicator Bacteria Present In Ice And Soda From Las Vegas Food Establishments, Kimberly Jo Hertin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Microbial analysis has long been used as an indicator of water quality. Since the passing of the Safe Drinking Water Act in 1974, microbial standards have been strictly set by the Environmental Protection Agency (EPA) to ensure that the public health is protected from bacterial pathogens. The bacteriological quality of water generally deteriorates as it travels from water treatment facilities through the main distribution system and into private plumbing and distribution systems. For example, Heterotrophic Plate Count (HPC) values typically increase once the water has entered plumbing devices such as beverage vending machines. Upon reaching a private facility, the opportunity …

Spatial Epidemiology And Temporal Trends Of Heart Attack And Stroke In Middle Tennessee, Doreen Busingye

Masters Theses

Despite declines in mortality risks of myocardial infarction (MI) and stroke in the US since the 1960’s, the burdens of these conditions remain high. These conditions require emergency and specialized care and therefore quick transportation of patients to appropriate hospitals is critical. Geographic disparities in MI and stroke burdens have been consistently reported in the US with the south-east having the highest risks. Most studies of geographic disparities have been performed at county or higher geographic units. Therefore, spatial patterns at neighborhood levels are unclear. Moreover, it’s important to investigate disparities at neighborhood levels to better understand neighborhood health needs. …

An Examination Of Diet, Acculturation And Risk Factors For Heart Disease Among Jamaican Immigrants, Carol Renee Oladele

USF Tampa Graduate Theses and Dissertations

Background: The South Florida region is home to over 85,000 Jamaican immigrants. Yet, little is known about the dietary intakes and predictors of risk of disease within this immigrant group. An assessment of dietary intakes and the development of dietary intake methodologies specific to the Jamaican population was important as it permitted accurate estimation of the nutrient intakes of this immigrant population whose dietary habits are not well documented. In addition, nothing is known about the prevalence of risk factors for heart disease or factors influencing risk factors among this immigrant group. The purpose of this study was to assess …

Micronutrient Intake And Premenstrual Syndrome, Patricia O. Chocano-Bedoya

Open Access Dissertations

Premenstrual syndrome (PMS) is characterized by the presence of physical and psychological symptoms restricted to the late luteal phase of the menstrual cycle and associated with substantial impairment in life activities. In the U.S. about 8 to 15% of women of reproductive age suffer from PMS. Many micronutrients are potentially involved in the development of this disorder due to their role in the synthesis of neurotransmitters and hormones or in their regulation, but few previous studies have evaluated the effects of micronutrients on PMS. The first study examined the association between B vitamin intakes, and PMS development among women participating …

Gene By Bmi Interactions Influencing C-Reactive Protein Levels In European-Americans, Sarah Tudor

Dissertations & Theses (Open Access)

C-Reactive Protein (CRP) is a biomarker indicating tissue damage, inflammation, and infection. High-sensitivity CRP (hsCRP) is an emerging biomarker often used to estimate an individual’s risk for future coronary heart disease (CHD). hsCRP levels falling below 1.00 mg/l indicate a low risk for developing CHD, levels ranging between 1.00 mg/l and 3.00 mg/l indicate an elevated risk, and levels exceeding 3.00 mg/l indicate high risk. Multiple Genome-Wide Association Studies (GWAS) have identified a number of genetic polymorphisms which influence CRP levels. SNPs implicated in such studies have been found in or near genes of interest including: CRP, APOE, APOC, IL-6, …

A Comparison Of Spatio-Temporal Prediction Methods Of Cancer Incidence In The U.S, Michelle Hamlyn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cancer is the cause of one out of four deaths in the United States, and in 2009, researchers expected over 1.5 million new patients to be diagnosed with some form of cancer. People diagnosed with cancer, whether a common or rare type, need to undergo treatments, the amount and kind of which will depend on the severity of the cancer. So how do healthcare providers know how much funding is needed for treatment? What would better enable a pharmaceutical company to determine how much to allocate for research and development of drugs, the amount of each drug to manufacture, or …

Characterization Of The Serologic Responses To Plasmodium Vivax Dbpii Variants Among Inhabitants Of Pursat Province, Cambodia, Samantha Jones Barnes

USF Tampa Graduate Theses and Dissertations

The Plasmodium vivax Duffy Binding Protein (DBP) is the ligand in the major pathway for P. vivax invasion of human reticulocytes, making it an appealing vaccine candidate. Region II of DBP (DBP-RII) is the minimal portion of the ligand that mediates recognition of the Duffy Antigen Receptor for Chemokines (DARC receptor) on the reticulocyte surface and constitutes the primary vaccine target. Analysis of natural variation in the coding sequences of DBP-RII revealed signature evidence for selective pressure driving variation in the residues of the putative receptor-binding site. We hypothesize that anti-DBP immunity in P. vivax infections is strain-specific and hindered …

Exploring Geographic Proximity To Fast-Food Restaurants And Convenience Stores With Dental Caries In Patients At The University Of Nevada Las Vegas School Of Dental Medicine, Charles K. Hill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dental caries is present worldwide and has afflicted over 90% of all adults in the United States. Biological determinants of the disease are well understood but social determinants and how they interact with biological factors are not. Programs designed to reduce incidence and prevalence of caries often target certain individuals and involve behavioral change. Some programs are more successful when environmental and societal issues are also addressed (Watt, 2002). Biological and behavioral processes leading to caries should include the modification of social factors to enhance results of prevention programs designed to reduce caries in populations. Preventing disease comes not only …

Modeling Mortality Rates For Leukemia Between Men And Women In The United States, Blessed Quansah

UNLV Theses, Dissertations, Professional Papers, and Capstones

Leukemia related deaths increased dramatically over the last forty years. Leukemia is a malignant disease or cancer of the bone marrow and blood. It is characterized by the uncontrolled accumulation of blood cells. Leukemia is divided into two categories: myelogenous or lymphocytic, each of which can be acute or chronic. The terms, myelogenous or lymphocytic denote the cell type involved.

In this thesis, the proposed modeling techniques are applied to leukemia deaths data from the Surveillance Epidemiology and End Results (SEER). In particular, annual deaths data from 1969 to 2007 are used in the data analysis, which includes three major …

Contextual Factors And Reproductive Control In U.S. Women, Brianna Magnusson

Theses and Dissertations

Introduction: Access to family planning services is a major public health issue. State policies and funding for family planning services may increase access to contraceptive services and help women avoid unintended pregnancies. Study Design: We identified sexually active, fertile women participants of the National Survey of Family Growth (2006-2008). Women were categorized as consistent or inconsistent users of contraceptives based on self-report. States were classified based on 2006 Medicaid family planning waiver status (income expansions, limited expansions, or no Medicaid family planning expansions), 2006 public funding for family planning in dollars per woman, and insurance coverage of contraceptive mandate status …

Depressive Symptoms In Mothers Of Children With New-Onset Epilepsy: A Prospective Study, Mark Anthony Ferro

Electronic Thesis and Dissertation Repository

Having a child diagnosed with a chronic illness such as epilepsy is a major source of stress for caregivers. Up to half of mothers of children with epilepsy are at increased risk for clinical depression and symptoms of maternal depression are associated with poorer health outcomes in these children. The purpose of this study was to: 1) estimate the prevalence and course of depressive symptoms over 24 months among mothers of children with new-onset epilepsy; 2) identify subgroups of mothers that share similar trajectories of depressive symptoms; and, 3) assess the family factors involved in the causal pathway between maternal …

The Epidemiology Of Human Rabies Postexposure Prophylaxis In Virginia, 2002 And 2003, Marilyn Goss Haskell

Theses and Dissertations

Objective: To describe a sample that received human rabies postexposure prophylaxis (PEP) in Virginia as a result of animal exposures in 2002 and 2003 and to determine the extent to which PEP decisions were appropriate.Methods: PEP surveillance data were requested from 35 Virginia health districts within 5 regions. Retrospective chart review was used to gather demographic, exposure and source animal data from patient records and animal exposure reports. Descriptive statistics are presented. True exposures and appropriateness of PEP were defined using the 2004 Virginia Rabies Control Guidelines and the Recommendations of the 1999 Advisory Committee on Immunization Practices. The 2003 …

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 …

The Effect Of Phytoestrogen Chemoprevention Of Prostate Cancer, Ruel Slyfield Michelin

Walden Dissertations and Doctoral Studies

Prostate cancer (CaP) remains the most commonly diagnosed cancer and second leading cause of cancer mortality among men in several ethnic groups in the United States. Lower CaP incidence among Asian men has been attributed to increased intake of soy derived phytoestrogens (SDPs); however, its association has not been extensively explored in U.S. men. The purpose of this study was to determine the effect size of serum prostate specific antigen (sPSA) and serum estradiol (sE2) following dietary SDP intervention. The study was based on an original conceptual model that aims to avert early prostate tissue damage through identification of critical …

Perspectives Of Women In Nairobi Kenya Toward Malaria Control, Catherine Kisavi-Atatah

Walden Dissertations and Doctoral Studies

Malaria infection has been and continues to be a serious public health concern that has mystified many in the public health care industry. One area in Sub Saharan Africa that continues to feel the devastating effects of malaria is in Nairobi, Kenya. This qualitative research study explored the attitudes of women in Nairobi, Kenya and how they view intervention measures already introduced by public health care experts in fighting malaria. The phenomenological research approach used purposeful sampling to recruit 16 women from Nairobi, Kenya to participate in semi-structured, open-ended interviews. The ecological systems theory was used as a lens of …

Assessing The Influence Of Socioeconomic Factors, Knowledge Level, Attitudes, And Practices On Malaria Prevention Among The Gusii People Of Kenya, Christopher Nyakundi Arori

Walden Dissertations and Doctoral Studies

Global morbidity and mortality associated with malaria is rampant, and most of the clinical malaria cases are found in sub Saharan Africa. Previous and current research show that malaria is both preventable and treatable and that socioeconomic variables have a profound influence on how persons in rural Africa respond to malaria infections and the associated preventive strategies. This study assessed two key research questions for malaria cases in the Gusii region of Kenya regarding: First, whether a community education program on malaria has an impact in changing malaria preventive behaviors; and, second, if a relationship exists between socioeconomic factors and …

The Relationship Between Daily Snowfall Accumulation And Pattern And Severity Of Traumatic Injuries At A U.S. Ski Resort, S. Jason Moore

Walden Dissertations and Doctoral Studies

Throughout the relevant literature, research addressing the impact of a specific environmental factor, such as snowfall, on injury patterns or severity among alpine skiers and snowboarders is sparse. The foundation for inquiry into this relationship was developed based on principles of physics and traumatology coupled with findings in the available literature. Secondary analysis of trauma registry data coupled with daily snowfall measurements from one of the largest ski areas in North America illustrated a negative correlation between daily snowfall amount and injury severity (r = -.08). Concordant findings demonstrated an increased odds of sustaining an injury defined as severe or …

The Relationship Of Provider Cultural Competence And Utilization Of Prenatal Care In The Hmong Of Minnesota, Cynthia J. Larson

Walden Dissertations and Doctoral Studies

Experts suggest that the cultural competence of healthcare providers is a critical factor impacting healthcare services to the ethnically diverse patient populations in the U.S. and that it may play a role in improving outcomes and reducing health disparities; however, the association between cultural competence and health outcomes remains unclear. This study used a cross-sectional quantitative design grounded by cultural competency constructs and the ethnic origins theory to explore the relationships between provider cultural competence, adequacy of prenatal care, and neonatal health outcomes in Hmong women, a population whose cultural beliefs affect their use of early and adequate prenatal care. …

Differences In Breast Cancer Tumor Size, Stage, And Survival By Socioeconomic Position In Young Women, Julie Maureen Tomaska

Walden Dissertations and Doctoral Studies

Although the incidence of breast cancer in women under 40 years of age is somewhat rare, young women tend to present with cancer that is more advanced and with poorer prognostic characteristics. This research will be important to providers, women and their families and those seeking to clarify screening guidelines. The purpose of this quantitative, retrospective, cohort study was to evaluate differences in prognostic characteristics by socioeconomic position (SIP). The cohort was comprised of females aged 18 to 39 with a primary diagnosis of breast cancer. Data were obtained from the Surveillance, Epidemiology and End Results registry for all primary …

Association Between Vegan, Vegetarian, And Omnivorous Diets And Overweight And Obesity, Daniel Sullivan

Walden Dissertations and Doctoral Studies

Overweight and obesity and associated health risks have become epidemic in several regions around the world. Numerous studies have addressed the dietary habits of vegetarians and vegans in terms of disease prevention and nutritional deficiencies but the relationship between overweight and obesity and the demographic, psychosocial, lifestyle, and dietary intake of omnivores, vegetarians, and vegans has received less attention. Guided by the social-ecological model, this study included a cross-sectional, quantitative, anonymous web-based survey to obtain dietary information on omnivores, vegetarians, and vegans. Vegans demonstrated a significantly lower mean and median body mass index ( p=0.00) than omnivores, semi-vegetarians, and vegetarians. …

Analysis Of Risk Factors Associated With Asymptomatic Colonization Of Methicillin Resistant Staphylococcus Aureus (Mrsa) Among Community College Students, Marilynn Kish-Molina

Walden Dissertations and Doctoral Studies

The bacterium Staphylococcus aureus has been an important human ailment for centuries, and with the overuse of antibiotics, methicillin resistant Staphylococcus aureus (MRSA) has emerged as a deadly, costly pathogen worldwide. Healthy carriers can become sick or can spread MRSA without symptoms. The amount of asymptomatic colonization among healthy college students and risk factors for colonization by MRSA are not well understood. According to the epidemiologic triangle model, the host (students who take antibiotics or have a history of skin infections), the infectious agent (MRSA) and the environment (direct contact with people, animals, or objects that may harbor MRSA) all …

A Sibling Case-Control Study Of Maternal Prenatal Body Mass Index As A Risk Factor For Autism Spectrum Disorder, Ruth Ann Hendrix

Walden Dissertations and Doctoral Studies

The prevalence of autism spectrum disorder (ASD) is estimated to be one in every 150 births. While both genetic and postpartum environmental exposure have been linked to ASD, prenatal maternal weight has not been investigated. The objective of the study is to assess whether overweight or obesity at pregnancy is an important risk factor for the diagnosis of ASD in offspring. A case-control study was designed to answer this question using the public health ecosocial theory. The study population consisted of 70 mothers, who were recruited via the Internet using the viral expansion loop. Multiple logistic regression analysis was used …

Gender Differences In Lung Cancer Treatment And Survival, Margaret Anne Kowski

USF Tampa Graduate Theses and Dissertations

The objectives of this research were to test treatment and survival differences between women and men with lung cancer as there is minimal investigation in the literature. Three research questions were developed with statistical testing for gender differences based on similar cancer type, stage, treatment assignment and survival. Data for 44,863 primary lung cancer cases were collected from eight U.S. state-based cancer registries to investigate the research questions. The lung cancer incidence data included the morphological cell-types of adenocarcinoma (AC); squamous cell carcinoma (SCC); large cell carcinoma (LCC) and small cell carcinoma (SCC). Stage, grade, treatment type, as well as, …

Case-Control Study Of Sunlight Exposure And Cutaneous Human Papillomavirus Seroreactivity In Basal Cell And Squamous Cell Carcinomas Of The Skin, Michelle R. Iannacone

USF Tampa Graduate Theses and Dissertations

Non-melanoma skin cancer (NMSC), comprised of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is the most common cancer in Caucasians. Ultraviolet radiation (UVR) exposure is the most important environmental risk factor for both BCC and SCC development. However, the precise relationship between UVR and the risk of NMSC is complex, and the relationship may differ by skin cancer type. It has been hypothesized that intermittent patterns and childhood sunlight exposure are important for BCC while continuous (chronic) and lifelong (i.e. childhood and adulthood) sunlight exposure is important for SCC. Epidemiologic studies have demonstrated that cutaneous human papillomavirus (HPV) …

The Natural History Of Human Papillomavirus Related Condyloma In A Multinational Cohort Of Men, Gabriella Anic

USF Tampa Graduate Theses and Dissertations

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, but few studies have examined the progression from HPV infection to disease in men. Genital condyloma are the most common clinical manifestation of HPV infection. Though not associated with mortality, condyloma are a source of emotional distress, and treatment is often painful with a high recurrence rate. The aims of this study were to examine the distribution of HPV types present on the surface of condyloma, estimate the incidence of condyloma overall and after type-specific HPV infections, assess the sociodemographic and sexual behavior factors independently associated …