Medicine and Health Sciences Commons^™

On Kernel-Based Estimator Of Odds Ratio Using Different Stratified Sampling Schemes, Abbas Eftekharian, Hani Samawi, Haresh Rochani

Department of Biostatistics, Epidemiology, and Environmental Health Sciences Faculty Publications

The kernel-based estimator of Cochran Mantel-Haenszel odds ratio based on stratified simple and ranked set sampling is proposed. The expectation and variance of the estimator are analytically obtained. Using a simulation study, the estimator based on stratified ranked set sampling is more efficient than its counterpart based on stratified simple random sampling. Finally, the estimator's performance is investigated by using base deficit data.

Medical Racism: Comparing Prenatal Care Across Races In The United States, Rubina Cheema

Student Research

Prenatal care describes any care a woman receives during her pregnancy. It is intended to keep both the mother and the child healthy and also to reduce the risk of complications during and after birth. This care is especially important for women with high-risk factors so that doctors and nurses are able to monitor their health and the health of their baby during the duration of their pregnancy. For prenatal care to be most effective, it is imperative to begin prenatal care within the first trimester of a woman's pregnancy. However, in the United States, medical racism creates a major …

Predictors Of Covid-19 Vaccination Rate In Usa: A Machine Learning Approach, Syed M. I. Osman, Ahmed Sabit

WCBT Faculty Publications

In this study, we examine state-level features and policies that are most important in achieving a threshold level vaccination rate to curve the effects of the COVID-19 pandemic. We employ CHAID, a decision tree algorithm, on three different model specifications to answer this question based on a dataset that includes all the states in the United States. Workplace travel emerges as the most important predictor; however, the governors’ political affiliation (PA) replaces it in a more conservative feature set that includes economic features and the growth rate of COVID-19 cases. We also employ several alternative algorithms as a robustness check. …

Evaluating The Health Impacts Of Fruit And Vegetable Intake At The Individual Level And Food Pantry Level Among Food Pantry Users, Jiacheng Chen

Legacy Theses & Dissertations (2009 - 2024)

Background: Chronic diseases impose heavy burdens on individuals and the healthcare system in the US. Many factors were found to be associated with chronic diseases, including demographics, family history, social environmental factors, and individual behavioral factors such as diet and physical activity. Among those factors, fruit and vegetable intake can have substantial health impacts via a variety of causal pathways. Fruit and vegetable (F&V) consumption is generally lower among individuals living in households experiencing food insecurity and rely on food assistance programs. Decreased F&V intake among food pantry users may negatively impact health. However, conducting quantitative analysis on this population …

Metabolic Alterations And Cardiovascular Risk After Hepatitis C Cure In Subjects With Or At Risk For Hiv, Christophe Maxime Fokoua Dongmo

Legacy Theses & Dissertations (2009 - 2024)

Background. Hepatitis C virus (HCV) infection engenders substantial metabolic changes. These changes are altered when the virus is cleared after successful treatment. We measured these metabolic alterations that occur after HCV cure; further, we assessed whether these alterations differed in subgroups defined by patients’ characteristics.

Use Of Healthcare Utilization Records For Analyzing Trends In Clinical Toxoplasmosis: A Comparison Of Nevada And The United States, Elijah Kreutzer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Toxoplasmosis, a zoonotic disease caused by the parasitic protist Toxoplasma gondii, is a ubiquitous, global public health concern with a wide variety of clinical manifestations. Surveillance for the disease is lacking even in developed countries, and what surveillance is present most often focuses on pregnant women. This research investigated trends in clinical toxoplasmosis in Nevada and nationally to address the lack of knowledge concerning how Nevada discharges compare to national discharges in cases of toxoplasmosis. Specifically, this research sought to determine what characterizes toxoplasmosis in Nevada across inpatient, outpatient, and emergency department settings, as well as how these cases differ …

Bayesian Methods For Graphical Models With Neighborhood Selection., Sagnik Bhadury

Electronic Theses and Dissertations

Graphical models determine associations between variables through the notion of conditional independence. Gaussian graphical models are a widely used class of such models, where the relationships are formalized by non-null entries of the precision matrix. However, in high-dimensional cases, covariance estimates are typically unstable. Moreover, it is natural to expect only a few significant associations to be present in many realistic applications. This necessitates the injection of sparsity techniques into the estimation method. Classical frequentist methods, like GLASSO, use penalization techniques for this purpose. Fully Bayesian methods, on the contrary, are slow because they require iteratively sampling over a quadratic …

A Bootstrap Method For A Multiple-Imputation Variance Estimator In Survey Sampling, Lili Yu, Yichuan Zhao

Department of Biostatistics, Epidemiology, and Environmental Health Sciences Faculty Publications

Rubin’s variance estimator of the multiple imputation estimator for a domain mean is not asymptotically unbiased. Kim et al. derived the closed-form bias for Rubin’s variance estimator. In addition, they proposed an asymptotically unbiased variance estimator for the multiple imputation estimator when the imputed values can be written as a linear function of the observed values. However, this needs the assumption that the covariance of the imputed values in the same imputed dataset is twice that in the different imputed datasets. In this study, we proposed a bootstrap variance estimator that does not need this assumption. Both theoretical argument and …

Pandemic Fatigue Impedes Mitigation Of Covid-19 In Hong Kong, Zhanwei Du, Lin Wang, Songwei Shan, Dickson Lam, Tim K. Tsang, Jingyi Xiao, Huizhi Gao, Bingyi Yang, Sheikh Taslim Ali, Sen Pei, Isaac Chun-Hai Fung, Eric H. Y. Lau, Qiuyan Liao, Peng Wu, Lauren Ancel Meyers, Gabriel M. Leung, Benjamin Cowling

Department of Biostatistics, Epidemiology, and Environmental Health Sciences Faculty Publications

Hong Kong has implemented stringent public health and social measures (PHSMs) to curb each of the four COVID-19 epidemic waves since January 2020. The third wave between July and September 2020 was brought under control within 2 m, while the fourth wave starting from the end of October 2020 has taken longer to bring under control and lasted at least 5 mo. Here, we report the pandemic fatigue as one of the potential reasons for the reduced impact of PHSMs on transmission in the fourth wave. We contacted either 500 or 1,000 local residents through weekly random-digit dialing of landlines …

Association Between The Health Belief Model, Exercise, And Nutrition Behaviors During The Covid-19 Pandemic, Keagan Kiely, Bill Mase, Andrew R. Hansen, Jessica S. Schwind

Department of Biostatistics, Epidemiology, and Environmental Health Sciences Faculty Publications

Introduction: The COVID-19 pandemic has affected our nation’s health further than the infection it causes. Physical activity levels and dietary intake have suffered while individuals grapple with the changes in behavior to reduce viral transmission. With unique nuances regarding the access to physical activity and nutrition during the pandemic, the constructs of Health Belief Model (HBM) may present themselves differently in nutrition and exercise behaviors compared to precautions implemented to reduce viral transmission studied in previous research. The purpose of this study was to investigate the extent of exercise and nutritional behavior change during the COVID-19 pandemic and explain the …

Improving The Accuracy Of Interactive Voice Response (Ivr) Technology For Pediatric Experience Scores, Elizabeth Spaargaren Ms, Mph, Cpxp, Abigail Kozak Mba, Cpxp, Cara Herbener Cpxp, Barbara Lawlor Burke Ma, Cpxp

Patient Experience Journal

The increased use of interactive voice response (IVR) in assessing patient and family experience should be paired with evidence-based practices on how to obtain the most accurate information via this survey mode. We added a brief clarification sentence of the survey scale at the start of the IVR call to improve our experience data both qualitatively and quantitatively. Our setting was an urban pediatric hospital. We gathered lived experiences from our patients, families, and providers to understand and design a change to the IVR survey mode that would reduce survey inaccuracies. Outcome measures were assessed by baseline measurement and post-intervention …

Higher Adherence To A Mediterranean Diet Is Associated With Improved Insulin Sensitivity And Selected Markers Of Inflammation In Individuals Who Are Overweight And Obese Without Diabetes, Surbhi Sood, Jack Feehan, Catherine Itsiopoulos, Kirsty Wilson, Magdalena Plebanski, David Scott, James Hébert Scd, Nitin Shivappa Mbbs, Mph, Ph.D., Aya Mousa, Elena S. George, Barbora De Courten

Faculty Publications

Insulin resistance (IR) and chronic low-grade inflammation are risk factors for chronic diseases including type 2 diabetes (T2D) and cardiovascular disease. This study aimed to investigate two dietary indices: Mediterranean Diet Score (MDS) and Dietary Inflammatory Index (DII®), and their associations with direct measures of glucose metabolism and adiposity, and biochemical measures including lipids, cytokines and adipokines in overweight/obese adults. This cross-sectional study included 65 participants (males = 63%; age 31.3 ± 8.5 years). Dietary intake via 3-day food diaries was used to measure adherence to MDS (0–45 points); higher scores indicating adherence. Energy-adjusted DII (E-DII) scores were calculated with …

The Impact Of Meal Dietary Inflammatory Index On Exercise-Induced Changes In Airway Inflammation In Adults With Asthma, Katrina P. Mcdiarmid, Lisa G. Wood, John W. Upham, Lesley K. Macdonald-Wicks, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Hayley A. Scott

Faculty Publications

Research suggests exercise may reduce eosinophilic airway inflammation in adults with asthma. The Dietary Inflammatory Index (DII®) quantifies the inflammatory potential of the diet and has been associated with asthma outcomes. This study aimed to determine whether the DII of a meal consumed either before or after exercise influences exercise-induced changes in airway inflammation. A total of 56 adults with asthma were randomised to (1) 30–45 min moderate–vigorous exercise, or (2) a control group. Participants consumed self-selected meals, two hours pre- and two hours post-intervention. Energy-adjusted DII (E-DIITM) was determined for each meal, with meals then characterised as “anti-inflammatory” or …

Examining The Association Between A Modified Quan Charlson Comorbidity Index (Qcci) And Viral Suppression: A Cross Sectional Analysis Of Dc Cohort Participants, Hasmin C. Ramirez, Lauren O’Connor, Morgan Byrne, Anne Monroe

Epidemiology Faculty Posters and Presentations

No abstract provided.

Quality Of Life In Older And Younger People With Hiv And Diabetes, Lauren F. O’Connor, La’Marcus Wingate, Sam Simmens, Amanda D. Castel, Anne K. Monroe

Epidemiology Faculty Posters and Presentations

No abstract provided.

Cancer Incidence And Stage At Diagnosis Among People With Psychotic Disorders: Systematic Review And Meta-Analysis., Jared C Wootten, Joshua C Wiener, Phillip S Blanchette, Kelly K. Anderson

Epidemiology and Biostatistics Publications

Research regarding the incidence of cancer among people with psychotic disorders relative to the general population is equivocal, although the evidence suggests that they have more advanced stage cancer at diagnosis. We conducted a systematic review and meta-analysis to examine the incidence and stage at diagnosis of cancer among people with, relative to those without, psychotic disorders. We searched the MEDLINE, EMBASE, PsycINFO, and CINAHL databases. Articles were included if they reported the incidence and/or stage at diagnosis of cancer in people with psychotic disorders. Random effects meta-analyses were used to determine risk of cancer and odds of advanced stage …

Classification Of Breast Cancer Histopathological Images Using Semi-Supervised Gans, Balaji Avvaru, Nibhrat Lohia, Sowmya Mani, Vijayasrikanth Kaniti

SMU Data Science Review

Breast cancer is diagnosed more frequently than skin cancer in women in the United States. Most breast cancer cases are diagnosed in women, while children and men are less likely to develop the disease. Various tissues in the breast grow uncontrollably, resulting in breast cancer. Different treatments analyze microscopic histopathology images for diagnosis that help accurately detect cancer cells. Deep learning is one of the evolving techniques to classify images where accuracy depends on the volume and quality of labeled images. This study used various pre-trained models to train the histopathological images and analyze these models to create a new …

Predicting Insulin Pump Therapy Settings, Riccardo L. Ferraro, David Grijalva, Alex Trahan

SMU Data Science Review

Millions of people live with diabetes worldwide [7]. To mitigate some of the many symptoms associated with diabetes, an estimated 350,000 people in the United States rely on insulin pumps [17]. For many of these people, how effectively their insulin pump performs is the difference between sleeping through the night and a life threatening emergency treatment at a hospital. Three programmed insulin pump therapy settings governing effective insulin pump function are: Basal Rate (BR), Insulin Sensitivity Factor (ISF), and Carbohydrate Ratio (ICR). For many people using insulin pumps, these therapy settings are often not correct, given their physiological needs. While …

Cov-Inception: Covid-19 Detection Tool Using Chest X-Ray, Aswini Thota, Ololade Awodipe, Rashmi Patel

SMU Data Science Review

Since the pandemic started, researchers have been trying to find a way to detect COVID-19 which is a cost-effective, fast, and reliable way to keep the economy viable and running. This research details how chest X-ray radiography can be utilized to detect the infection. This can be for implementation in Airports, Schools, and places of business. Currently, Chest imaging is not a first-line test for COVID-19 due to low diagnostic accuracy and confounding with other viral pneumonia. Different pre-trained algorithms were fine-tuned and applied to the images to train the model and the best model obtained was fine-tuned InceptionV3 model …

Dietary Inflammatory Index And Mortality From All Causes, Cardiovascular Disease, And Cancer: A Prospective Study, Zhen Lin, Yanfei Feng, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Xin Xu

Faculty Publications

The Energy-adjusted Dietary Inflammatory Index (E-DIITM) is a comprehensive, literature-derived index for assessing the effect of dietary constituents on inflammatory biomarkers and inflammation-related chronic diseases. Several studies have examined the association between E-DII scores and mortality, with results that vary across populations. Therefore, in the present study, we aimed to investigate the potential association between E-DII scores and all-cause, cardiovascular disease (CVD), and cancer mortality using data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Screening Trial. E-DII scores, calculated based on a food-frequency questionnaire, were analyzed both as a continuous variable and after categorization into quintiles. A multivariate Cox …

Processed Food As A Risk Factor For The Development And Perpetuation Of Crohn's Disease-The Enigma Study, Gina L. Trakman, Winnie Y.Y. Lin, Amy L. Hamilton, Amy L. Wilson-O'Brien, Annalise Stanley, Jessica Y. Ching, Jun Yu, Joyce W.Y. Mak, Yang Sun, Junkin Niu, Yinglei Miao, Xiaoqing Lin, Rui Feng, Minhu Chen, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Mark Morrison, Siew C, Ng, Michael A. Kamm

Faculty Publications

(1) Background: Developing countries have experienced a rapid recent rise in Inflammatory Bowel Disease (IBD) incidence and emerging evidence suggests processed foods and food additives may predispose one to the development and perpetuation of Crohn’s disease (CD). The aim of this study was to evaluate processed food and food additive intake in CD patients and controls, in Australia (high CD incidence), Hong Kong (intermediate incidence) and mainland China (emerging incidence). (2) Methods: In 274 CD patients (CD), 82 first-degree relatives (FDR), 83 household members (HM) and 92 healthy unrelated controls (HC) from Australia (n = 180), Hong Kong (HK) (n …

Cancer Incidence And Stage At Diagnosis Among People With Recent-Onset Psychotic Disorders: A Retrospective Cohort Study Using Health Administrative Data From Ontario, Canada., Jared C Wootten, Lucie Richard, Phillip S Blanchette, Joshua C. Wiener, Kelly K. Anderson

Epidemiology and Biostatistics Publications

OBJECTIVE: Prior evidence on the relative risk of cancer among people with psychotic disorders is equivocal. The objective of this study was to compare incidence and stage at diagnosis of cancer for people with psychotic disorders relative to the general population.

METHOD: We constructed a retrospective cohort of people with a first diagnosis of non-affective psychotic disorder and a comparison group from the general population using linked health administrative databases in Ontario, Canada. The cohort was followed for incident diagnoses of cancer over a 25-year period. We used Poisson and logistic regression models to compare cancer incidence and stage at …

Spatial Analysis Of Seven Islands In Indonesia To Determine Stunting Hotspots, Tiopan Sipahutar, Tris Eryando, Meiwita Budiharsana

Kesmas

Indonesia is a vast country struggling to reduce its stunting prevalence. Hence, identifying priority areas is urgent. In determining areas to prioritize, one needs to consider geographical issues, particularly correlations among areas. This study aimed to discover whether stunting prevalence in Indonesia occurs randomly or in clusters; and, if it occurs in clusters, which areas are the hotspots. This ecological study used aggregate data from the 2018 National Basic Health Research and Poverty Data and Information Report from the Statistics Indonesia. This study analyzed 514 districts/cities across 34 provinces on seven main islands in Indonesia. The method used was the …

Perspectives On Reproductive Health Education Among Javanese Parents, Bagoes Widjanarko, Ratih Indraswari, Aditya Kusumawati, Novia Handayani

Kesmas

This study aimed to investigate the perspectives of reproductive health education among Javanese parents of children aged 9-11 years. This cross-sectional study was conducted with 12,306 parents in Semarang City, Central Java Province, Indonesia, using a purposive sampling technique. Some parents agreed that reproductive health education at home was unnecessary (29.5%), taboo (45%), difficult (73.1%), and awkward (41.5%). Most parents (72.7%) were not transparent in providing reproductive health information to their children by using other terms to name the genitals, considering the politeness aspect. Good practices of providing reproductive health information are slightly more common in mothers (54.2%), unemployed parents …

Predictors Of Anxiety Toward Covid-19 Delta Variant: A Cross- Sectional Study Among Healthcare Providers In Java And Bali, Indonesia, I Ketut Swarjana, I Gede Putu Darma Suyasa, I Kadek Nuryanto

Kesmas

Health facilities are experiencing overcapacity, oxygen scarcity, and a limited number of healthcare providers due to the coronavirus disease 2019 (COVID-19), thus impacted on anxiety. This study aimed to determine predictors of anxiety among healthcare providers toward the Delta variant of COVID-19 in Indonesia. A cross-sectional study was conducted with 371 healthcare providers in Java and Bali Islands, and the snowball sampling technique was used. Data were collected using a questionnaire and distributed through social media (WhatsApp), then analyzed using univariate analysis, bivariate analysis (Chi-square test), and multivariate analysis (multiple logistic regression). The results showed that 81 (21.8%) respondents experienced …

Model Autonomy Of Self-Finance Management For Primary Health Care To Enhance Workers’ Satisfaction, Ahmad Jet Alamin, Ossama Issac, Lina Teo, Atikah Adyas

Kesmas

This study aimed to find an appropriate model of autonomous self-finance management in primary health care (PHC) to enhance workers' satisfaction. This was a cross-sectional study in which data were collected through self-administered questionnaires from 204 workers in ten Regional Public Service Agency for Primary Health Care (RPSAPHC)/Badan Layanan Umum Daerah Pusat Kesehatan Masyarakat (BLUD Puskesmas) in Tangerang District, Banten Province, Indonesia using the partial least squares and structural equation model (PLS-SEM). A total of 73 indicators were used to examine the PHC transformation process to enhance workers' satisfaction. The indicators were grouped into three variables depending on workers' satisfaction: …

Determinants Of Type 2 Diabetes Mellitus Among Passive Smokers, Adinda Rahma Triyaniarta, Santi Martini, Kurnia Dwi Artanti, Sri Widati, Rizma Dwi Nastiti

Kesmas

Type 2 diabetes mellitus (T2DM) leads to complications of other diseases. The modifiable risk factors for T2DM are overweight, physical activity, hypertension, unhealthy diet, and smoking. This study aimed to analyze determinants of T2DM incidence in passive smokers among various factors. This study was conducted at Hospital X in Surabaya City, East Java Province, Indonesia, from September 2019 to April 2020. The variables were univariate, bivariate, and multivariate. Case samples were T2DM patients and passive smokers, while control samples were non-T2DM patients and passive smokers, with 52 respondents per group, of 104 total respondents. Variables statistically significant related to the …

The Effect Of Health Promotion Program On Perceived Self-Efficacy And Self-Care Practices Among Elderly With Multimorbidity In Chiang Mai, Thailand, Jukkrit Wungrath, Nuttida Khumai, Phinphot Phrommasen

Kesmas

Multimorbidity in the elderly is a major public health issue with serious consequences. This study investigated the effects of health promotion programs on perceived self-efficacy and self-care practices among the elderly with multimorbidity using a quasi-experimental study design from February to July 2021. The study samples were the elderly from Doi Saket District, Chiang Mai Province, Thailand, selected by a multistage random sampling technique. The experimental and control groups each comprised 40 elderlies with multimorbidity. All elderly participants took part in a 12-week health promotion program. The perceived self-efficacy and self-care practices of the study samples were assessed using interviews, …

A Stunting Prevention Risk Factors Pathway Model For Indonesian Districts/Cities With A Stunting Prevalence Of ≥30%, Nina Fentiana, Endang L. Achadi, Besral Besral, Abram Kamiza, Trini Sudiarti

Kesmas

The prevalence of stunting in Indonesian children aged 0-23 months is a public health problem caused by direct and indirect factors. This study aimed to discover the path of the relationship between various risk factors and the stunting prevalence of ≥30% in 165 districts/cities in Indonesia. Data were obtained from the 2018 National Basic Health Research, National Socioeconomic Survey, and the Statistics Indonesia with a cross-sectional approach. The secondary data on stunting and risk factors were aggregated at the district/city level from individual data; children aged 0-23 months. The path analysis used to determine a stunting prevention model showed that …

Spatial Analysis For Enhancing The Use Of Health Data Availability From Different Sources To Help The Decision-Making Process, Tris Eryando

Kesmas

Spatial analysis in public health has become a common method used by researchers to understand the distribution of public health aspects related to the surrounding environment. It can also be used to analyze individual information in the form of a dot and the location or line of aggregated information in a specific area of study. Another benefit is the possibility of using different data sources to be analyzed in one statistical model analysis, as long as the identification area is sufficiently clear as a key variable. Spatial analysis can show an object's distribution on a locational map and explain the …