Public Health Commons^™

Combating Sti Epidemic: Community Perspectives Learned From Mixed-Gender Focus Group Study, K. M. M. Islam, Laura C. Vinson, Sherri Nared, Ira Combs, Melissa Tibbits, Shinobu Watanabe-Galloway, Ruth Margalit

Journal Articles: Epidemiology

Background. Since 2004, Douglas County in Nebraska has been experiencing higher rates of sexually transmitted infections (STIs) than the rest of the state. Northern Omaha has been considered to be one of the “hot spots” for STIs in the county. In 2011-2012, a focus group study was conducted to investigate the community’s perception of STIs and to identify strategies to increase the testing and treatment of STIs. Methods. Fourteen young adults were recruited to participate in two mixed-gender focus group sessions, each lasting 1.5 hours. Sessions covered various topics on STIs. Audio-recorded sessions were transcribed and analyzed by …

Comparing Two-Year Community College And Four-Year University Student Social And Behavioral Sexually Transmitted Infection Risk Factors, Oswald M. Attin

Faculty Dissertations

Sexually transmitted infections (STIs) could cause ectopic, cervical cancer, infertility, and organ damage to the heart, kidneys, and brain. This study compared several behavioral risk factors of STIs (condom use, number of sexual partners, type of sex (anal or vaginal) and drinking habits) between two distinct educational settings and their association with socioeconomic risk factors such as low income and parent’s lower level of education that are known to increase the incidence of STIs among college-aged students. This study was based on the precautionary-health-behavior model, where individuals act regardless of consequences, and the health-behavior-change model, where individual behaviors either increase …

Condom Negotiation Across Different Relationship Types By Young Women Engaged In Sex Work In Phnom Penh, Cambodia, Lisa Maher, Julie Mooney-Somers, Pisith Phlong, Marie-Claude Couture, Serey Serey Kien, Ellen Stein, Anna Juong Bates, Neth Sansothy, Kimberly Page, Young Women's Health Study Collaborative

Nursing and Health Professions Faculty Research and Publications

Cambodia’s 100% Condom Use Programme is credited with an increase in consistent condom use in commercial sexual interactions and a decrease in HIV prevalence among female sex workers (FSWs). There has been little improvement in condom use between FSWs and non-commercial partners, prompting calls for more innovative approaches to increasing condom use in these relationships. To understand why condoms are used or not used in sexual interactions involving FSWs, we examined condom negotiation across different types of relationships. We conducted 33 in-depth interviews with young (15 to 29 years) women engaged in sex work in Phnom Penh. There was an …

Information And Communication Technology To Link Criminal Justice Reentrants To Hiv Care In The Community, Ann Kurth, Irene Kuo, James Peterson, Nkiru Azikiwe, Lauri Bazerman, Alice Cates, Curt G. Beckwith

Epidemiology Faculty Publications

The United States has the world’s highest prison population, and an estimated one in seven HIV-positive persons in the USA passes through a correctional facility annually. Given this, it is critical to develop innovative and effective approaches to support HIV treatment and retention in care among HIV-positive individuals involved in the criminal justice (CJ) system. Information and communication technologies (ICTs), including mobile health (mHealth) interventions, may offer one component of a successful strategy for linkage/retention in care. We describe CARE+ Corrections, a randomized controlled trial (RCT) study now underway in Washington, that will evaluate the combined effect of computerized motivational …

Determinants Of Negative Pathways To Care And Their Impact On Service Disengagement In First-Episode Psychosis., Kelly K. Anderson, Rebecca Fuhrer, Norbert Schmitz, Ashok K Malla

Epidemiology and Biostatistics Publications

PURPOSE: Although there have been numerous studies on pathways to care in first-episode psychosis (FEP), few have examined the determinants of the pathway to care and its impact on subsequent engagement with mental health services.

METHODS: Using a sample of 324 FEP patients from a catchment area-based early intervention (EI) program in Montréal, we estimated the association of several socio-demographic, clinical, and service-level factors with negative pathways to care and treatment delay. We also assessed the impact of the pathway to care on time to disengagement from EI services.

RESULTS: Few socio-demographic or clinical factors were predictive of negative pathways …

Obesity And Preference-Weighted Quality Of Life Of Ethnically Diverse Middle School Children: The Healthy Study, Roberto P. Trevino, Trang H. Pham, Sharon Edelstein

GW Biostatistics Center

No abstract provided.

Transmission Potential Of Influenza A/H7n9, February To May 2013, China, Gerardo Chowell, Lone Simonsen, Sherry Towers, Mark A. Miller, Cecile G. Viboud

Epidemiology Faculty Publications

Background

On 31 March 2013, the first human infections with the novel influenza A/H7N9 virus were reported in Eastern China. The outbreak expanded rapidly in geographic scope and size, with a total of 132 laboratory-confirmed cases reported by 3 June 2013, in 10 Chinese provinces and Taiwan. The incidence of A/H7N9 cases has stalled in recent weeks, presumably as a consequence of live bird market closures in the most heavily affected areas. Here we compare the transmission potential of influenza A/H7N9 with that of other emerging pathogens and evaluate the impact of intervention measures in an effort to guide pandemic …

A Case–Control Study Of Incident Rheumatological Conditions Following Acute Gastroenteritis During Military Deployment, Kathryn Deyoung, Mark A. Riddle, Larissa S. May, Chad K. Porter

Epidemiology Faculty Publications

Objectives The aim of this study was to assess the risk of incident rheumatological diagnoses (RD) associated with self-reported diarrhoea and vomiting during a first-time deployment to Iraq or Afghanistan. Such an association would provide evidence that RD in this population may include individuals with reactive arthritis (ReA) from deployment-related infectious gastroenteritis.

Design This case–control epidemiological study used univariate and multivariate logistic regression to compare the odds of self-reported diarrhoea/vomiting among deployed US military personnel with incident RD to the odds of diarrhoea/vomiting among a control population.

Setting We analysed health records of personnel deployed to Iraq or Afghanistan, including …

Community Knowledge, Attitude And Practice About Malaria In A Low Endemic Setting Of Shewa Robit Town, Northeastern Ethiopia, Andargie Abate, Abraham Degarege, Berhanu Erko

Journal Articles: Epidemiology

BACKGROUND: Since malaria is one of the foremost public health problems in Ethiopia, assessment of situation of the disease, and communities' knowledge and perceptions about malaria is necesary to institute appropriate preventive and control measures. Thus, the aim of this study was to assess malaria prevalence and knowledge, attitude and practice (KAP) about the disease among ShewaRobit Town community, northeastern Ethiopia.

METHODS: A community-based cross-sectional study was conducted in Shewa Robit Town from October to November 2011. A multi-stage random sampling technique was used to select the study participants. A total of 425 individuals were examined for malaria using thin …

Gaps In Survey Data On Cancer In American Indian And Alaska Native Populations: Examination Of Us Population Surveys, 1960-2010, Shinobu Watanabe-Galloway, Tinka Duran, Jim P. Stimpson, Corey Smith

Journal Articles: Epidemiology

INTRODUCTION: Population-based data are essential for quantifying the problems and measuring the progress made by comprehensive cancer control programs. However, cancer information specific to the American Indian/Alaska Native (AI/AN) population is not readily available. We identified major population-based surveys conducted in the United States that contain questions related to cancer, documented the AI/AN sample size in these surveys, and identified gaps in the types of cancer-related information these surveys collect.

METHODS: We conducted an Internet query of US Department of Health and Human Services agency websites and a Medline search to identify population-based surveys conducted in the United States from …

Illness-Related Diabetes Social Support And Glycemic Control Among Middle Aged And Older Adults, Favel Leah Mondesir

Theses and Dissertations

Objective

The objective of this study is to investigate the association between illness-related diabetes social support (IRDSS) and glycemic control (GC) among a racially diverse sample of middle aged and older adults. In gender-stratified models we examine whether the relationship between IRDSS and GC is modified by race/ethnicity. Additionally, we explore the association between eight individual types of IRDSS and GC.

Methods

We used the Health and Retirement Study (HRS) 2002 and the 2003 Diabetes Survey. The final analytic sample consisted of 914 study respondents. Gender-stratified multivariable logistic regression models were used to calculate odd ratios (ORs) and 95% confidence …

The Psychological Impacts Of False Positive Ovarian Cancer Screening: Assessment Via Mixed And Trajectory Modeling, Amanda T. Wiggins

Theses and Dissertations--Epidemiology and Biostatistics

Ovarian cancer (OC) is the fifth most common cancer among women and has the highest mortality of any cancer of the female reproductive system. The majority (61%) of OC cases are diagnosed at a distant stage. Because diagnoses occur most commonly at a late-stage and prognosis for advanced disease is poor, research focusing on the development of effective OC screening methods to facilitate early detection in high-risk, asymptomatic women is fundamental in reducing OC-specific mortality. Presently, there is no screening modality proven efficacious in reducing OC-mortality. However, transvaginal ultrasonography (TVS) has shown value in early detection of OC. TVS presents …

Task-Based Noise Exposures For Farmers Involved In Grain Production, Michael J. Humann, Wayne T. Sanderson, Kelley J. Donham, Kevin M. Kelly

Epidemiology and Environmental Health Faculty Publications

Few studies have been done examining noise exposures associated with agricultural tasks. This study was conducted to address that research gap by calculating the noise exposures for tasks and equipment associated with grain production and assessing the variability in those exposures. An additional aim of this study was to identify tasks and equipment that could be targeted for intervention strategies as a means toward reducing the total noise exposures of farmers and farm workers. Through the use of personal noise dosimetry and direct observation, over 30,000 one-minute noise exposure measurements and corresponding task and equipment data were collected on 18 …

Epidemiology Of Hospital Acquired Methicillin Resistant Staphylococcus Aureus In A Veterans Affairs Medical Center Spinal Cord Injury Unit: Fiscal Years 2008-2011, Rebecca B. Stone

College of Graduate Studies: Theses & Dissertations

The purpose of this retrospective case-control study was to assess risk factors contributing to hospital acquired methicillin Staphylococcus aureus (HA-MRSA) and gain a better understanding of the burden of HA-MRSA infection in patients with spinal cord injuries. The study was also conducted to see if new information would be found on HA-MRSA infections and validate or refute current research for patients in a dedicated spinal cord injury unit at a Veterans Affairs Medical Center. During the study period, the infection control department identified 95 cases of HA-MRSA. Additional data retrospectively collected were basic demographics, admitting diagnosis, presence of varying comorbidities, …

In Utero Exposure To Antiretroviral Medication And Congenital Malformation Outcomes In New York State 1998-2010, Stephen Goins

Legacy Theses & Dissertations (2009 - 2024)

Objective: To examine the relationships between HIV ARV use during pregnancy and congenital malformations outcomes in New York State.

Hypertension Prevalence Among Adults In The United States (Nhanes 2007-2010) : Are There Race And Hispanic Origin Differences?, Philip M. Dimura

Legacy Theses & Dissertations (2009 - 2024)

Purpose: To investigate the prevalence of hypertension across race and ethnic categories in the National Health and Nutrition Examination Survey for years 2007 to 2010.

Alternative Vaccination Schedules (Avs) : Detection Of Avs In New York State Using Immunization Registry Data, Jessica A. Nadeau

Legacy Theses & Dissertations (2009 - 2024)

Intentional deviation from the recommended childhood vaccine schedule (RVS), referred to as an alternative vaccination schedule (AVS) is becoming increasingly prevalent in the United States. Physicians may accommodate vaccine-hesitant parents with an AVS as a compromise position to allow some vaccinations to be given, but in doing so children remain vulnerable to vaccine-preventable disease for a longer period of time. This research expands upon the nascent literature by proposing a unified definition of AVS, quantifying the prevalence of infants following an AVS in New York State (NYS) (exclusive of New York City) by geographic area and community and medical practice …

Exposure To Persistent Organic Pollutants And Metabolic Diseases, Zafar Zayirovich Aminov

Legacy Theses & Dissertations (2009 - 2024)

Background: The metabolic syndrome (MetS) is a group of diseases that tend to occur together, including diabetes, hypertension, central obesity, cardiovascular disease and hyperlipidemia. Exposure to persistent organic pollutants (POPs) such as polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) have been associated with increased risk of development of several of the components of the MetS.

Quantitative Evaluation Of Antibiotic Exposure-Response Relationships Among Patients With Serious Staphylococcal Infections, Thomas Patrick Lodise

Legacy Theses & Dissertations (2009 - 2024)

This dissertation advances our understanding of antimicrobial exposure-response relationships among patients with serious infections due to Staphylococcus aureus. The need is pressing as treatment of this invasive pathogen has been complicated by the development of antibiotic resistance. One antibiotic resistant phenotype of particular concern is methicillin-resistant S. aureus (MRSA). Due to the multi-drug resistant nature of most MRSA strains, vancomycin emerged as the cornerstone of therapy. Although widely used for serious MRSA infections, many clinicians now question its continued utility due to the emergence of MRSA strains with reduced vancomycin susceptibility phenotypes (rVSPs). The literature is developing rapidly, but characterization …

The Potential For Bridging : Hiv Status Awareness And Risky Sexual Behavior Of Injection Drug Users Who Have Non-Injecting Permanent Partners In Ukraine, Alyona Mazhnaya

Legacy Theses & Dissertations (2009 - 2024)

Abstract

Using Administrative Data To Estimate The Burden Of Chlamydia Among Medicaid Managed Care Enrollees In New York State, Lindsay W. Cogan

Legacy Theses & Dissertations (2009 - 2024)

Infection with Chlamydia trachomatis is of public health concern because of its adverse effects on reproduction. Women infected with Chlamydia can develop pelvic inflammatory disease, which can lead to serious reproductive system morbidity including ectopic pregnancy and infertility.

Does Intimate Partner Violence Affect The Acceptability Of Expedited Partner Therapy?, Suzanne Elizabeth Beck

Legacy Theses & Dissertations (2009 - 2024)

Background: Studies have identified associations between intimate partner violence (IPV) and elevated risk of sexually transmitted infections (STI). An estimated 6% of women in the United States have experienced physical and/or sexual assault inflicted by an intimate partner in the previous year. Of those with an STI, chlamydia is disproportionately reported for women. In 2009, New York State legalized Expedited Partner Therapy (EPT) for chlamydial infections; however clinicians are lacking guidance with respect to appropriate use of EPT when IPV is a concern.

30-Day Readmission And Emergency Department Visits : Experience Of Diabetes And Abdominal Surgery Patients, Andrea Jane Mathis

Legacy Theses & Dissertations (2009 - 2024)

Nearly one-fifth of Medicare beneficiaries are readmitted within 30 days of a hospital stay. Readmissions contribute to the rising health care costs and they serve as a proxy for overall inpatient quality of care. Policy makers and payers interested in the efficacy of strategies to improve care coordination have scrutinized readmission rates for some time, yet this analysis attends to several remaining gaps in the literature. First, the rising prevalence of diabetes may be an underappreciated driver for readmissions. Second, many abdominal surgery patients require post-operative care, yet the point of care delivery and level of care needed has not …

Effect Of Data Aggregation At Two Geographic Levels On The Association Between Absms And Gonorrhea Rates In Nys, 1999-2001, Christina Michelle Gray

Legacy Theses & Dissertations (2009 - 2024)

This study compared the association between residential area factors and gonorrhea, aggregated at both the census tract versus ZIP code levels. Prior research has found that census block groupings are most optimal in neighborhood-level studies, followed by census tracts and ZIP codes. Because several healthcare databases currently only provide ZIP code level data, the aim of this study was to examine whether there exists a meaningful difference between the interpretation of census tract and ZIP code aggregate data. Our study measured the association between socioeconomic factors and gonorrhea in New York State, exclusive of New York City (NYC), census tracts …

Augmenting Program Data With Secondary Data Sources To Improve The Quality Of Existing Statistics : Four Examples From The New York State Department Of Health Hospital-Acquired Infection Reporting Program, Valerie Benson Haley

Legacy Theses & Dissertations (2009 - 2024)

The objective of this dissertation is to illustrate the novel application of methods that can be used to improve the accuracy of hospital-acquired infection (HAI) rates. Public reporting of HAI rates is relatively new. New York was one of the first states to mandate reporting in acute care hospitals (2007), followed by national pay-for-reporting in 2011, and national value-based purchasing in 2013. Given the financial ramifications of public reporting, it is critical that the data are validated and adjusted for differences in underlying risk among patient populations so that hospital performance can be fairly compared. However, limited information on the …

Using Geospatial Technologies To Characterize Relationships Between Travel Behavior, Food Availability, And Health, Warren J. Christian

Theses and Dissertations--Geography

Epidemic obesity in the U.S. has prompted exploration of causal factors related to the built environment. Recent research has noted statistical associations between the spatial accessibility of retail food sources, such as supermarkets, convenience stores, and restaurants, and individual characteristics such as weight, socioeconomic status, and race/ethnicity. These studies typically use residential proximity or neighborhood density to food sources as the measure of accessibility. Assessing food environments in this manner, however, is very limiting. Since most people travel outside of their neighborhood on a daily basis, the retail food sources available to individuals residing in the same area could vary …

Data Mining And Pattern Discovery Using Exploratory And Visualization Methods For Large Multidimensional Datasets, Hsin-Fang Li

Theses and Dissertations--Epidemiology and Biostatistics

Oral health problems have been a major public health concern profoundly affecting people’s general health and quality of life. Given that oral health data is composed of several measurable dimensions including clinical measurements, socio-behavioral factors, genetic predispositions, self-reported assessments, and quality of life measures, strategies for analyzing multidimensional data are neither computationally straightforward nor efficient. Researchers face major challenges to identify tools that circumvent the processes of manually probing the data.

The purpose of this dissertation is to provide applications of the proposed methodology on oral health-related data that go beyond identifying risk factors from a single dimension, and to …

Associations Between The Perceived And Built Food Environment, Timothy L. Barnes

Theses and Dissertations

Neighborhood food environments have been associated with dietary intake and obesity. Measures of the food environment have typically been characterized with geographic information systems (GIS)-based measures, however, the use of perception-based measures of the food environment have increased in frequency. Few studies have fully examined the relationship between perceptions and GIS-based measures of the food environment, especially considering the congruency between perceived and GIS-based presence of specific retail food outlets, nor the relationship between food outlets and perceived availability of healthy foods or fast food opportunities.

Telephone survey data from 705 residents in an eight-county region of South Carolina were …

A Preliminary Study Exploring Racial Differences In Triage, Hospitalization Status, And Discharge Medication In An Emergency Department In Graniteville, Sc, Clare Pollock

Theses and Dissertations

Purpose

This study seeks to identify any racial differences present in assigned triage scores, hospitalization status and discharge medications in a rural hospital likely experiencing a surge after a mass casualty incident involving chlorine gas as a result of a train derailment. Differences were examined between Non-Hispanic White and African American adults who were moderately ill and who presented to the emergency department of the closest hospital to the accident site within 24 hours of the incident.

Methods

Non-Hispanic White and African American adults who presented to the emergency department of the closest hospital to the accident site and who …

Cattle-Related Injuries And Farm Management Practices On Kentucky Beef Cattle Farms, Steven R. Browning, Susan C. Westneat, Wayne T. Sanderson, Deborah B. Reed

Epidemiology and Environmental Health Faculty Publications

While working on farms with livestock increases the risk of injury among farm workers in comparison to other commodity farms, few studies have examined the role offarm management practices in association with the risk of cattle-related injury. We examined the farm management practices of Kentucky beef cattle farms in association with self-reported rates of cattle-related injuries among workers. We conducted a mail survey of a random sample of 2,500 members of the Kentucky Cattlemen's Association. Results from 1,149 farm operators who were currently raising beef cattle and provided complete survey response are reported. During the busy season, the principal operator …