Public Health Commons^™

Heart Failure Outcomes With Empagliflozin In Patients With Type 2 Diabetes At High Cardiovascular Risk: Results Of The Empa-Reg Outcome® Trial., David Fitchett, Bernard Zinman, Christoph Wanner, John M. Lachin, Stefan Hantel, Afshin Salsali, Odd Erik Johansen, Hans J Woerle, Uli C Broedl, Silvio E Inzucchi

Epidemiology Faculty Publications

AIMS: We previously reported that in the EMPA-REG OUTCOME(®) trial, empagliflozin added to standard of care reduced the risk of 3-point major adverse cardiovascular events, cardiovascular and all-cause death, and hospitalization for heart failure in patients with type 2 diabetes and high cardiovascular risk. We have now further investigated heart failure outcomes in all patients and in subgroups, including patients with or without baseline heart failure.

METHODS AND RESULTS: Patients were randomized to receive empagliflozin 10 mg, empagliflozin 25 mg, or placebo. Seven thousand and twenty patients were treated; 706 (10.1%) had heart failure at baseline. Heart failure hospitalization or …

Maternal, Environmental, And Social Context Predicts Diarrheal Infection Incidence In Young Children In Sundarbans, India, Sohini Mukherjee, Laura M. Glynn

Student Scholar Symposium Abstracts and Posters

Diarrheal infection is the third leading cause of childhood mortality in India and is responsible for 13% of all deaths per year in children under 5 years of age (Lakshaminarayan & Jayalakshmy, 2015). The Sundarbans in West Bengal is amongst the poorest regions of India and is the epitome of abject deprivation and the acute struggle against geographical and socioeconomic challenges. The incidence of diarrhea in this region is considerably high; about 42,000 reported cases occur per month, and one in five diarrhea cases are reported as severe (with blood in stool). In addition, 37% of children hospitalized for ailments …

Epidemiology News, Georgia Southern University

Biostatistics, Epidemiology & Environmental Health Sciences: News & Publications (2011-2018)

• Georgia Southern Students Receive Awards from Rural Health Conference

A Yellow Fever Epidemic: A New Global Health Emergency?, Lawrence O. Gostin, Daniel Lucey

Georgetown Law Faculty Publications and Other Works

The worst yellow fever epidemic in Angola since 1986 is rapidly spreading, including the capital, Luanda. In Angola, the epidemic began in December 2015 and the laboratory-confirmed outbreak was reported to the World Health Organization (WHO) on January 21, 2016. Angola has had 2023 suspected cases and 258 deaths as of April 26, 2016. China, the Democratic Republic of Congo, and Kenya also have reported cases arising from infected travelers from Angola. Namibia and Zambia also share a long border with Angola, with considerable population movement between the countries. Similar to other recent epidemics, quick and effective action to stop …

Hospital Mortality In The United States Following Acute Kidney Injury, Jeremiah. R. Brown, Michael E. Rezaee, Emily J. Marshall, Michael E. Matheny

Dartmouth Scholarship

Acute kidney injury (AKI) is a common reason for hospital admission and complication of many inpatient procedures. The temporal incidence of AKI and the association of AKI admissions with in-hospital mortality are a growing problem in the world today. In this review, we discuss the epidemiology of AKI and its association with in-hospital mortality in the United States. AKI has been growing at a rate of 14% per year since 2001. However, the in-hospital mortality associated with AKI has been on the decline starting with 21.9% in 2001 to 9.1 in 2011, even though the number of AKI-related in-hospital deaths …

Global Trends In Cancer Burden Based On Geographic Location, Socio-Economic Status And Demographic Shift, Sanjib Chowdhury

Theses & Dissertations

The global burden of cancer is rising at an alarming rate. It remains as one of the top causes of morbidity and mortality worldwide. It is predicted that within 2020, there will be 15 million new cases of cancer in the world, with cancer-related deaths increasing to 12 million. According to the World Health Organization (WHO), the global cancer burden is expected to surge 57% worldwide in the next 20 years. A significant rise in cancer burden will occur in the low-income and middle-income (developing) countries not only due to demographic shifts, but also by the transition of risk factors …

Human Papillomavirus And Its Impact On Vulnerable Populations, Harpriya Kaur

Theses & Dissertations

Human papillomavirus (HPV) is the most common sexually transmitted infection. The infection is higher in certain racial/ethnic groups and those who are immunocompromised including pregnant women. Because immune system is suppressed during pregnancy, women are at higher risk of various types of infection including HPV, a known risk factor for pregnancy complications. However, its role in adverse pregnancy outcomes is unclear. Another high risk population is Northern Plain American Indian. In the Northern Plains region, American Indian women have significantly higher rate of HPV infection than white counterparts and are infected with different types of HPVs than the general population. …

Epidemiology News, Georgia Southern University

Biostatistics, Epidemiology & Environmental Health Sciences: News & Publications (2011-2018)

• Georgia Southern Estimates the Effects of Smoking Bans on Neonatal Health

An Integrated Strategy For Strengthening Worcester's Regional Food System: Key Roles For Education And Information, Joel Simonson

Sustainability and Social Justice

Food security and access to healthy food are public health issues that continue to persist in the United States and are ones that are strongly influenced by social and environmental factors. In Worcester, Massachusetts there are many organizations that contribute to alleviating the resulting effects, but do not always have the capacity to reach full potential and expand upon current initiatives. Students can provide existing human resources and knowledge that would benefit all parties. This would allow for organizational capacity development, ultimately impacting local residents, and for students to gain deeper connections to the greater Worcester community while learning vital …

Facilitating Effective Communication Between First Responders And Older Adults During Fall Incidents: An Educational Intervention, Krystin M. Beeman, Erica L. Berger, Isabel A. Cabezas, Nicole M. Mathews

Dissertations, Masters Theses, Capstones, and Culminating Projects

PURPOSE. The purpose of this project was to provide first responders with communication strategies for older adults that may help when responding to fall- related calls. General information was also provided to First Responders on working with older adults with a focus on the aging process, fall risk factors, and communications strategies.

METHODS. A series of educational sessions to first responders at a local fire district were developed and presented by occupational therapy students. Materials were developed by presenters from evidence-based resources and tailored to the target population. Each presentation focused on statistics about older adults, the aging process, fall …

Assessing Adult Tobacco Smoking Cessation In Low-And-Middle Income Countries: Analysis Of The Global Adult Tobacco Survey Data, 2009 – 2012, Daniel Owusu

Electronic Theses and Dissertations

Smoking cessation can reduce health risk and prevent millions of tobacco-related deaths. However, cessation rates are low in low-and-middle income countries (LMICs), with only a small proportion of smokers intending to quit. Given the paucity of literature to support tobacco cessation programs in LMICs, this study aimed to: 1) identify factors associated with intention to quit smoking, 2) assess the relationship between health care provider quit advice/tobacco screening and utilization of cessation assistance, and 3) examine the relationship between home smoking rule and smoking intensity across three stages of smoking cessation (precontemplation, contemplation and preparation) in LMICs. Data were obtained …

Epidemiological Characteristics Of Clinically-Confirmed Cases Of Chikungunya In Teculutan, Guatemala, Annaly Aldana

Senior Honors Projects

As no vaccine currently exists for the Chikungunya virus (CHKV), mosquito control and efficient public health campaigns are crucial for the prevention of disease propagation. The purpose of this research project is to identify populations particularly at-risk for acquiring Chikungunya, and to explore the role that cultural attitudes may play in impacting mosquito-borne disease. Due to its geographical structure and climate, Guatemala is an ideal territory for the spread of emerging and re-emerging mosquito-borne diseases. This project was developed by collaborating with the public governmental health clinic in the municipal town of Teculután, in the department of Zacapa in Guatemala. …

Differences In Perceived Importance Of Preventative Services And Healthcare Provider Trust Among Hispanics, Jonathan James Gore

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Hispanic population varies greatly in their risk factors, health outcomes and access to care by country of origin, level of education and language dominance (Vega & Amaro, 1994) (Fiscella, Franks, Doescher, & Saver, 2002b). The differences within the Hispanic population also extend to their knowledge and attitudes toward health choices and maintenance, where they receive their health information, and what they access to meet their health care needs. Subpopulations within the Hispanic community as defined by language dominance and nativity must be understood as separate and distinct so that the health needs of each can be adequately addressed. The …

Cancer Among Asian American Population In The United States: Incidence And Survival Disparities, Hongbin Jin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Part I

Cancer incidence disparities exist among specific Asian American populations. However, the existing reports exclude data from large metropoles like Chicago, Houston, and New York. Moreover, incidence rates by subgroup have been underestimated due to the exclusion of Asians with unknown subgroup. Cancer incidence data for 2009 to 2011 for eight states accounting for 68% of the Asian American population were analyzed. Race for cases with unknown subgroup was imputed using stratified proportion models by sex, age, cancer site, and geographic regions. Age-standardized incidence rates were calculated for 17 cancer sites for the six largest Asian subgroups. Our analysis …

Network-Driven Plasma Proteomics Expose Molecular Changes In The Alzheimer's Brain, Philipp A. Jaeger, Kurt M. Lucin, Markus Britschgi, Badri Vardarajan, Ruo-Pan Huang, Elizabeth D. Kirby, Rachelle Abbey, Bradley F. Boeve, Adam L. Boxer, Lindsay A. Farrer, Nicole Finch, Neill R. Graff-Radford, Elizabeth Head, Matan Hofree, Ruochun Huang, Hudson Johns, Anna Karydas, David S. Knopman, Andrey Loboda, Eliezer Masliah, Ramya Narasimhan, Ronald C. Petersen, Alexei Podtelezhnikov, Suraj Pradhan, Rosa Rademakers, Chung-Huan Sun, Steven G. Younkin, Bruce L. Miller, Trey Ideker, Tony Wyss-Coray

Pharmacology and Nutritional Sciences Faculty Publications

Background: Biological pathways that significantly contribute to sporadic Alzheimer’s disease are largely unknown and cannot be observed directly. Cognitive symptoms appear only decades after the molecular disease onset, further complicating analyses. As a consequence, molecular research is often restricted to late-stage post-mortem studies of brain tissue. However, the disease process is expected to trigger numerous cellular signaling pathways and modulate the local and systemic environment, and resulting changes in secreted signaling molecules carry information about otherwise inaccessible pathological processes.

Results: To access this information we probed relative levels of close to 600 secreted signaling proteins from patients’ blood samples using …

Epidemiology Crucial To Cracking Elizabethkingia Crisis, Angela Tonozzi

Journal of Patient-Centered Research and Reviews

The author explains the epidemiological methods, tools and personnel required to pinpoint the source of Wisconsin’s 2016 outbreak of Elizabethkingia infections.

Continuum Of A Declining Trend In Correct Self-Perception Of Body Weight Among American Adults, Amber Morgan

GS4 Student Scholars Symposium

Background: Over the past few decades, the prevalence of obesity in the United States has steadily increased with the proportion of obese Americans projected to be about fifty percent in 2030. With more than half of adults being overweight or obese (OW/OB), an increasing number of adults failed to accurately perceive body weight, which may be a major barrier to weight loss strategies, thus, presenting a substantial challenge to prevention efforts. The objective of this study was to assess the dynamic trend of body weight related self-perception among American adults and provide recommendations for improving obesity prevention strategies.

Methods …

Effects Of Serum Levels Of Vitamin A And Precursors On Colorectal Cancer Mortlaity, Chimuanya Okoli

GS4 Student Scholars Symposium

Objective: To examine the relationship between serum levels of Vitamin A and precursors on Colorectal cancer mortality. Methods: A retrospective cohort study was conducted with 14,358 adults who participated in NHANES III. Data was collected via in home interviews and visits by participants to a mobile examination centre for blood sample collection. Characteristics such as family income, educational attainment, marital status, race and ethnicity, alcohol consumption, cigarette smoking, self reported health, type of resident, body size, cancer status at base line, vegetable consumption and fruit juice consumption were examined. Hazard ratio estimates for all-cause and cancer-related deaths among individuals with …

Association Between Fruit And Vegetable Consumption And Sleep Quantity In Pregnant Women, Kassandra Snook

GS4 Student Scholars Symposium

The National Sleep Foundation recommends an average sleep time duration of 7-9 hours per day for adults aged 18-64 years old. Unfortunately, women are prone to encounter sleep disruptions during pregnancy that can prevent them from the recommended amount of sleep. Poor sleep during pregnancy is associated with an increased risk for birth complications, including low birth weight and stillbirth. Studies have found that sleeping less and poor sleep quality is associated with lower consumption of fruits and vegetables and good sleep quality/adequate sleep is associated with increased fruit and vegetable consumption. The objective of this study was to determine …

Effect Of Natural Products Against Growth Of Three Allergenic And Toxigenic Molds, Brittany Loadholt, Teyaijah Givens, Nosa Lloyd Nwaonumah, Bushra Shah, Atin Adhikari

GS4 Student Scholars Symposium

Dampness and fungal exposures in buildings are widespread, with estimates ranging from 18% to 50% of buildings being affected. Of the 21.8 million people reported to have asthma in the USA, approximately 4.6 million cases are attributable to dampness and mold exposure in the home. Consequent national annual cost of asthma is about $3.5 billion. Several fungal genera from damp environments were reported to be associated with allergy and/or asthma and some species can release mycotoxins in the environment. Although there are several mold inhibitor or disinfectant solutions and sprays available in the market for cleaning and inhibiting mold growth, …

Analysis Of Relapse In Leukemia Patients With Missing Data Using An Extension Of The Em Algorithm, Braydon Schaible

GS4 Student Scholars Symposium

Introduction: Acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) are two types of acute leukemia. When complete remission of leukemia has not been achieved or the disease refracts to its stage in initial chemotherapy, relapse occurs. Leukemia has poor prognosis for patients with relapse. This sample included AML and ALL patients. The purpose of this study was to use and extension of the Expectation-Maximization (EM) algorithm in order to find significant factors that affect the occurrence of relapse in leukemia patients with missing data.

Methods: The EM logistic model consists of three steps. First, the initial logistic regression intercept …

Ebola And Social Media, Kathryn C. Finch

GS4 Student Scholars Symposium

We were interested in knowing the impact of social media during the 2014-2015 West Africa Ebola epidemic. The aim of this systematic review is to provide clinicians, public health practitioners and policy-makers with a comprehensive overview of the up-to-date literature on Ebola and social media. We critically appraised the quality and utility of these studies, and identified the gaps in our current understanding that invite further research efforts. In particular, we focused on the research questions and the methods of the studies: a) What were the research questions of a given study? b) What study design and research methods were …

Is The United States Prepared For A Major Zika Virus Outbreak?, Lawrence O. Gostin, James G. Hodge Jr.

Georgetown Law Faculty Publications and Other Works

Zika virus has emerged as a global public health crisis with active transmission in the Americas and Caribbean. The World Health Organization (WHO) declared a Public Health Emergency of International Concern (PHEIC), and recently WHO reported there is a scientific consensus that Zika is a cause of microcephaly and Guillain-Barré syndrome (GBS). In the U.S. the Centers for Disease Control and Prevention (CDC) activated its emergency operations center at its highest capacity. President Obama requested $1.86 billion in emergency funding. Shamefully, Congress has yet to appropriate the funding needed for Zika preparedness, and the President has had to reallocate Ebola …

Epidemiology News, Georgia Southern University

Biostatistics, Epidemiology & Environmental Health Sciences: News & Publications (2011-2018)

• Georgia Southern students assess characteristics for weight underestimation of children with obesity

The Role Of Mathematical Modeling In Designing And Evaluating Antimicrobial Stewardship Programs, Lester Caudill, Joanna R. Wares

Department of Math & Statistics Faculty Publications

Antimicrobial agent effectiveness continues to be threatened by the rise and spread of pathogen strains that exhibit drug resistance. This challenge is most acute in healthcare facilities where the well-established connection between resistance and sub-optimal antimicrobial use has prompted the creation of antimicrobial stewardship programs (ASPs). Mathematical models offer tremendous potential for serving as an alternative to controlled human experimentation for assessing the effectiveness of ASPs. Models can simulate controlled randomized experiments between groups of virtual patients, some treated with the ASP measure under investigation, and some without. By removing the limitations inherent in human experimentation, including health risks, study …

The Role Of Mathematical Modeling In Designing And Evaluating Antimicrobial Stewardship Programs, Lester Caudill, Joanna R. Wares

Department of Math & Statistics Faculty Publications

Antimicrobial agent effectiveness continues to be threatened by the rise and spread of pathogen strains that exhibit drug resistance. This challenge is most acute in healthcare facilities where the well-established connection between resistance and suboptimal antimicrobial use has prompted the creation of antimicrobial stewardship programs (ASPs). Mathematical models offer tremendous potential for serving as an alternative to controlled human experimentation for assessing the effectiveness of ASPs. Models can simulate controlled randomized experiments between groups of virtual patients, some treated with the ASP measure under investigation, and some without. By removing the limitations inherent in human experimentation, including health risks, study …

Suicidal Ideation In Patients Hospitalized For Emergency Medical Treatment Related To Physical Trauma: Effects Of Posttraumatic Stress And Depression, Erin E. Carney

Masters Theses & Specialist Projects

Survivors of physical trauma may be at increased risk for developing suicidal ideation and behavior both during and after their inpatient hospitalization for medical treatment of wounds. It remains to be understood why a population hospitalized for nonpsychiatric reasons may ultimately develop a desire to take their own life. The current study sought to answer this question by hypothesizing that symptoms of posttraumatic stress (PTS) and depression during the recovery period individually mediated the relationship between physical pain and suicidal ideation. Researchers assessed these relationships in 246 patients who were receiving emergency medical treatment for wounds associated with a physically …

Uncovering Local Trends In Genetic Effects Of Multiple Phenotypes Via Functional Linear Models, Olga A. Vsevolozhskaya, Dmitri V. Zaykin, David A. Barondess, Xiaoren Tong, Sneha Jadhav, Qing Lu

Biostatistics Faculty Publications

Recent technological advances equipped researchers with capabilities that go beyond traditional genotyping of loci known to be polymorphic in a general population. Genetic sequences of study participants can now be assessed directly. This capability removed technology-driven bias toward scoring predominantly common polymorphisms and let researchers reveal a wealth of rare and sample-specific variants. Although the relative contributions of rare and common polymorphisms to trait variation are being debated, researchers are faced with the need for new statistical tools for simultaneous evaluation of all variants within a region. Several research groups demonstrated flexibility and good statistical power of the functional linear …

Sex Disparities In Access To Acute Stroke Care: Can Telemedicine Mitigate This Effect?, Catherine Wolff, Amelia K. Boehme, Karen Albright, Tzu-Ching Wu, Michael Mullen, Sean Savitz, Charles Branas, James Grotta, Brendan Carr

Journal of Health Disparities Research and Practice

Background: Women have more frequent and severe ischemic strokes than men, and are less likely to receive treatment for acute stroke. Primary stroke centers (PSCs) have been shown to utilize treatment more frequently. Further, as telemedicine (TM) has expanded access to acute stroke care we sought to investigate the association between PSC, TM and access to acute stroke care in the state of Texas.

Methods: Texas hospitals and resources were identified from the 2009 American Hospital Association Annual Survey. Hospitals were categorized as: (1) stand-alone PSCs not using telemedicine for acute stroke care, (2) PSCs using telemedicine for acute stroke …

Investigating Pakistan’S Contraception Rate Plateau: A Multilevel Analysis To Understand The Association Between Community Contextual Factors And Modern Contraception Use, Mahmooda Khaliq Pasha

USF Tampa Graduate Theses and Dissertations

South Asia has the highest absolute number of women with an unmet need for contraception in the world. The total number of women with unmet need is 142 million. Of this, Asia accounts for 84 million followed by Sub-Saharan Africa at 32 million. Within South Asia, some countries have seen unmet need decrease and the contraception rate increase; however, Pakistan remains the exception to the rule. Pakistan has a low rate of contraception use, high rate of contraception discontinuation, high unmet need and high rate of unwanted fertility.

A number of theories have hypothesized that community-level factors influence a couple’s …