Public Health Commons^™

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. …

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 …

Decision Aid Models For Resource Sharing Strategies During Global Influenza Pandemics, Alfredo Santana Reynoso

USF Tampa Graduate Theses and Dissertations

Pandemic influenza outbreaks have historically entailed significant societal and economic disruptions. Today, our quality of life is threatened by our inadequate preparedness for the imminent pandemic. The key challenges we are facing stem from a significant uncertainty in virus epidemiology, limited response resources, inadequate international collaboration, and the lack of appropriate science-based decision support tools. The existing literature falls short of comprehensive models for global pandemic spread and mitigation which incorporate the heterogeneity of the world regions and realistic travel networks. In addition, there exist virtually no studies which quantify the impact of resource sharing strategies among multiple countries. This …

Indicators Of Early Adult And Current Personality In Parkinson's Disease, Kelly Sullivan

USF Tampa Graduate Theses and Dissertations

Introduction: Previous epidemiologic studies suggest that the personality of Parkinson's disease (PD) patients differs from that of controls, and laboratory evidence supports a potential common pathophysiology of personality traits and PD. One nested case-control study found that PD cases were significantly more anxious than controls before the clinical onset of the disease, and additional data suggest that certain occupations may be risk factors for the disease. Additionally, the latent period that precedes the onset of motor symptoms of PD is unknown.

Objectives: The objectives of this study were to evaluate the association of PD with objective indicators of current and …

Assessing The Relationship Of Monocytes With Primary And Secondary Dengue Infection Among Hospitalized Dengue Patients In Malaysia, 2010: A Cross-Sectional Study, Benjamin Glenn Klekamp

USF Tampa Graduate Theses and Dissertations

Dengue, a group of four similar viruses transmitted through the bite of a mosquito, is estimated to infect upwards of 100 million annually in over 100 nations throughout the global equatorial belt. Distribution of global dengue is highly skewed as Southeast Asian and Western Pacific regions endure 75% of the global dengue burden. Similar to other regional countries, Malaysia has been rapidly urbanizing, which has supported a hyperendemic dengue state.

The biological pathway by which dengue infection causes a wide range of clinical manifestations, spanning asymptomatic to life-threatening severe complications, is not comprehensively understood. Historically, severe dengue complications have primarily …

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) …

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, …

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 …

Disparities In Survival And Mortality Among Infants With Congenital Aortic, Pulmonary, And Tricuspid Valve Defects By Maternal Race/Ethnicity And Infant Sex, Colleen Conklin

USF Tampa Graduate Theses and Dissertations

Background: The etiology of congenital heart valve defects is not well understood; little is known about the risk factors that contribute to the survival and mortality outcomes of children with these defects.

Methods: Using data from the Texas Birth Defects Registry (TBDR) we conducted a retrospective cohort study of 2070 singleton infants with congenital aortic, pulmonary, or tricuspid valve atresia or stenosis born in Texas between January 1, 1996 and December 31, 2007 to Hispanic, Non-Hispanic (NH) black, and NH white women. TBDR data were death-to-birth matched by the Texas Vital Statistics Unit for deaths between January 1, 1996 and …

Evaluation Of Common Inherited Variants In Mitochondrial-Related And Microrna-Related Genes As Novel Risk Factors For Ovarian Cancer, Jennifer Permuth Wey

USF Tampa Graduate Theses and Dissertations

Epithelial ovarian cancer (EOC) is a leading cause of morbidity and mortality among women in the United States, and the etiology is incompletely understood. Common, low penetrant genetic variants such as single nucleotide polymorphisms (SNPs) likely contribute to a significant proportion of EOC. We examined whether SNPs in two understudied yet biologically important types of genes, mitochondrial-related and miRNA-related genes, may contribute to EOC susceptibility using data from a large, homogeneous study population of 1,815 EOC cases and 1,900 controls (frequency-matched on age-group and race/ethnicity) genotyped through stage 1 of an ongoing genome-wide association study. Inter-individual variation in genes involved …

Dna Methylation And Its Association With Prenatal Exposures And Pregnancy Outcomes, Jennifer Straughen

USF Tampa Graduate Theses and Dissertations

Altered DNA methylation may lead to suboptimal fetal programming, increasing the risk of adverse pregnancy outcomes such as small for gestational age (SGA); however, few studies have examined the associations between DNA methylation, prenatal exposures, and fetal outcomes. Cross-sectional data from a larger, ongoing study were used to assess the impact of prenatal smoking on gene specific methylation of umbilical cord blood derived DNA and to investigate the association between gene-specific methylation and risk of SGA. The association between gene-specific DNA methylation and birthweight was also assessed. Maternal and infant covariates were abstracted from medical records, cigarette smoke exposure was …

Gangguan Akibat Kekurangan Yodium Pada Wanita Usia Subur Di Kecamatan Baturaden Kabupaten Banyumas, Jawa Tengah, Endo Dardjito, Setiyowati Rahardjo

Kesmas

Gangguan Akibat Kekurangan Yodium (GAKY) merupakan salah satu masalah gizi di Kabupaten Banyumas. GAKY disebabkan oleh defisiensi kronik asupan yodium, konsumsi goitrogenik, penggunaan kontrasepsi KB hormonal, faktor genetik, dan pengetahuan penderita. Prevalensi penyakit gondok di Kecamatan Baturaden, Kabupaten Banyumas, terus meningkat mencapai 35,38% pada tahun 2007 sehingga daerah ini tergolong endemis berat GAKY. Untuk menganalisis faktor-faktor risiko GAKY di Kecamatan Baturaden, suatu penelitian penjelasan dengan desain kasus kontrol telah dilakukan dengan melibatkan 30 orang wanita usia subur (15-45 tahun) yang menderita GAKY sebagai kasus dan 30 orang WUS lain yang tidak menderita GAKY sebagai sebagai kontrol. Kedua kelompok adalah penduduk …

Mathematical Modeling, Simulation, And Time Series Analysis Of Seasonal Epidemics., Eric Shu Numfor

Electronic Theses and Dissertations

Seasonal and non-seasonal Susceptible-Exposed-Infective-Recovered-Susceptible (SEIRS) models are formulated and analyzed. It is proved that the disease-free steady state of the non-seasonal model is locally asymptotically stable if R_v < 1, and disease invades if R_v > 1. For the seasonal SEIRS model, it is shown that the disease-free periodic solution is locally asymptotically stable when R̅_v < 1, and I(t) is persistent with sustained oscillations when R̅_v > 1. Numerical simulations indicate that the orbit representing I(t) decays when R̅_v < 1 < R_v. The seasonal SEIRS model with routine and pulse vaccination is simulated, and results depict an unsustained decrease …

Coronary Heart Disease Mortality And Long-Term Exposure To Ambient Particulate Air Pollutants In Elderly Nonsmoking California Residents, Lie Hong Chen

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study is to assess the effect of long-term concentrations of ambient PM on risks of all causes, cardiopulmonary, coronary heart disease (CHD), total cancer, and any mention of nonmalignant respiratory disease (NMRD) mortality.

The health effects of long-term ambient air pollution have been studied with up to 30 years of follow-up in the AHSMOG cohort, a cohort of 6,338 nonsmoking white California adults. Monthly concentrations of ambient air pollutants [particulate matter(PMio), Ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2) or particulate matter

In the AHSMOG cohort, each increment of 10 |ig/m3 in PMio in two-pollutant models …

The Role Of Ambient Air Pollution In The Occurrence Of Emphysema, Shiva Metghalchi

Loma Linda University Electronic Theses, Dissertations & Projects

Emphysema is the most common cause of death from respiratory disease in the United States. Emphysema is most common among people aged 50 and older. Those with a genetic predisposition to emphysema may experience the onset as early as their thirties or forties. Men are more likely than women to develop emphysema, but female cases are increasing as the number of female smokers rises.

In the past few years, etiological and pathogenic research has been carried out in an attempt to determine the reason for an increase in deaths and other health problems associated with air pollution, and there have …

The Determinants Of Colorectal Cancer Survival Disparities In Nevada, Lucas N. Wassira

UNLV Theses, Dissertations, Professional Papers, and Capstones

Different population groups across Nevada and throughout the United States suffer disproportionately from colorectal cancer and its after-effects. Overcoming cancer health disparities is important for lessening the burden of cancer. There has been an overall decline in the incidence of and mortality from colorectal cancer (CRC). This is likely due, in part, to the increasing use of screening procedures such as Fecal Occult Blood Test (FOBT) and/or endoscopy, which can reduce the risk of CRC mortality by fifty percent. Nevertheless, screening procedures are routinely used by only fifty percent of Americans aged fifty years and older. Despite overall mortality decreasing …

Exploring Relationships Between Racism, Housing And Child Illness In Remote Indigenous Communities, Naomi Priest, Yin Paradies, Matthew Stevens, Ross Bailie

Aboriginal Policy Research Consortium International (APRCi)

Background Although racism is increasingly acknowledged as a determinant of health, few studies have examined the relationship between racism, housing and child health outcomes. Methods Cross-sectional data from the Housing Improvement and Child Health study collected in ten remote indigenous communities in the Northern Territory, Australia were analysed using hierarchical logistic regression. Carer and householder self-reported racism was measured using a single item and child illness was measured using a carer report of common childhood illnesses. A range of confounders, moderators and mediators were considered, including socio-demographic and household composition, psychosocial measures for carers and householders, community environment, and health-related …

Minimum Description Length And Empirical Bayes Methods Of Identifying Snps Associated With Disease, Ye Yang, David R. Bickel

COBRA Preprint Series

The goal of determining which of hundreds of thousands of SNPs are associated with disease poses one of the most challenging multiple testing problems. Using the empirical Bayes approach, the local false discovery rate (LFDR) estimated using popular semiparametric models has enjoyed success in simultaneous inference. However, the estimated LFDR can be biased because the semiparametric approach tends to overestimate the proportion of the non-associated single nucleotide polymorphisms (SNPs). One of the negative consequences is that, like conventional p-values, such LFDR estimates cannot quantify the amount of information in the data that favors the null hypothesis of no disease-association.

We …

The Handling Of Missing Data In Molecular Epidemiologic Studies, Manisha Desai, Jessica Kubo, Denise Esserman, Mary Beth Terry

COBRA Preprint Series

Background: Molecular epidemiologic studies face a missing data problem as biospecimen data are often collected on only a proportion of subjects eligible for study.

Methods: We investigated all molecular epidemiologic studies published in CEBP in 2009 to characterize the prevalence of missing data and to elucidate how the issue was addressed. We considered multiple imputation (MI), a missing data technique that is readily available and easy to implement, as a possible solution.

Results: While the majority of studies had missing data, only 16% compared subjects with and without missing data. Furthermore, 95% of the studies with missing data performed a …

The Use Of Multiple Imputation In Molecular Epidemiologic Studies Assessing Interaction Effects, Manisha Desai, Denise Esserman, Marilie Gammon, Mary Beth Terry

COBRA Preprint Series

Background: In molecular epidemiologic studies biospecimen data are collected on only a proportion of subjects eligible for study. This leads to a missing data problem. Missing data methods, however, are not typically incorporated into analyses. Instead, complete-case (CC) analyses are performed, which result in biased and inefficient estimates.

Methods: Through simulations, we characterized the bias that results from CC methods when interaction effects are estimated, as this is a major aim of many molecular epidemiologic studies. We also investigated whether standard multiple imputation (MI) could improve estimation over CC methods when the data are not missing at random (NMAR) and …

The Pathways To Mental Health Care Of First-Episode Psychosis Patients: A Systematic Review., Kelly K. Anderson, Rebecca Fuhrer, Ashok K. Malla

Epidemiology and Biostatistics Publications

BACKGROUND: Although there is agreement on the association between delay in treatment of psychosis and outcome, less is known regarding the pathways to care of patients suffering from a first psychotic episode. Pathways are complex, involve a diverse range of contacts, and are likely to influence delay in treatment. We conducted a systematic review on the nature and determinants of the pathway to care of patients experiencing a first psychotic episode.

METHOD: We searched four databases (Medline, HealthStar, EMBASE, PsycINFO) to identify articles published between 1985 and 2009. We manually searched reference lists and relevant journals and used forward citation …

The Health Of Latinos In Massachusetts: A Snapshot, Dharma Cortés, Rodolfo R. Vega

Gastón Institute Publications

People’s health outcomes are shaped in part by non-biological factors. Most immediately, limited access to health care services can have a deleterious impact on individuals’ health outcomes (Andrulis, 1998). In turn, access to healthcare services is influenced by socioeconomic factors such as whether a person has health insurance or the financial means to pay for their health care. Familiarity with the health care system is another important factor that may influence an individual’s access to healthcare services (Morgan et al., 2008). Language also plays an important role in health outcomes. For instance, individuals with limited English proficiency may find it …

Concurrent Sexual Partnerships Do Not Explain The Hiv Epidemics In Africa: A Systematic Review Of The Evidence, Larry Sawers, Eileen Stillwaggon

Economics Faculty Publications

The notion that concurrent sexual partnerships are especially common in sub-Saharan Africa and explain the region’s high HIV prevalence is accepted by many as conventional wisdom. In this paper, we evaluate the quantitative and qualitative evidence offered by the principal proponents of the concurrency hypothesis and analyze the mathematical model they use to establish the plausibility of the hypothesis.

We find that research seeking to establish a statistical correlation between concurrency and HIV prevalence either finds no correlation or has important limitations. Furthermore, in order to simulate rapid spread of HIV, mathematical models require unrealistic assumptions about frequency of sexual …

The Efficacy Of Spirometry As A Screening Tool In Detection Of Air Flow Obstruction, Nabeel Manzar, A. Suleman Haque, Bushra Manzar, Muhammad Irfan

Section of Pulmonary & Critical Care

Background/Objectives: In developing countries, spirometry has not been considered a part of routine medical check-up. The purpose of the study was to establish the usefulness of spirometry as a primary screening tool in detecting air flow obstruction (AFO) during routine medical check-up (RMC). Methods: This was a hospital based, retrospective, non-randomized case series study of 3696 participants, who presented to hospital for routine medical check-up. All subjects were assisted at the Pulmonary Medicine Department, from January 2003 till December 2008 who, having met other inclusion criteria, underwent spirometry. Data were analyzed using proportion, group means, standard deviations and …

Kie Untuk Peningkatan Pengetahuan, Sikap, Dan Praktik Pencegahan Dan Penanggulangan Penyakit Flu Burung Di Kabupaten Gowa, Sulawesi Selatan, Ridwan M. Said, M. Ridwan Thaha, M. Syafar

Kesmas

Avian influenza adalah suatu kejadian luar biasa yang disebabkan oleh virus influenza subtipe H5N1, ditularkan oleh ternak liar atau domestik dan kemungkinan menyerang manusia. Tujuan penelitian ini untuk mengungkapkan peningkatan pengetahuan masyarakat , perubahan sikap dan partisipasi masyarakat dalam pencegahan dan penanganan influenza di Kabupaten Bontonompo, Gowa. Desain riset adalah desain kuantitatif kuasi eksperimen. Penelitian ini dilakukan pada 120 peternak unggas sebagai sampel yang dipilih dengan metode purposive sampling dan menggunakan metoda analisis uji statistic T-Test. Penelitian membuktikan bahwa sebelum intervensi model pendidikan komunikasi informasi dilakukan, pengetahuan, sikap dan praktik pencegahan dan pengendalian avian influenza terbatas. Setelah intervensi informasi, pendidikan …

Surrogate Screening Models For The Low Physical Activity Criterion Of Frailty, Sandrah P. Eckel, Karen Bandeen-Roche, Paulo H.M. Chaves, Linda P. Fried, Thomas A. Louis

Johns Hopkins University, Dept. of Biostatistics Working Papers

Background and Aims. Low physical activity, one of five criteria in a validated clinical phenotype of frailty, is assessed by a standardized questionnaire on up to 20 leisure time activities. Because of the time demanded to collect the interview data, it has been challenging to translate to studies other than the Cardiovascular Health Study (CHS), for which it was developed. Considering subsets of activities, we identified and evaluated streamlined surrogate assessment methods and compared them to one implemented in the Women’s Health and Aging Study (WHAS).

Methods. Using data on men and women ages 65 and older from the CHS, …

Growth, Immune And Viral Responses In Hiv Infected African Children Receiving Highly Active Antiretroviral Therapy: A Prospective Cohort Study., Philippa M. Musoke, Peter Mudiope, Linda N. Barlow-Mosha, Patrick Ajuna, Danstan Bagenda, Michael M. Mubiru, Thorkild Tylleskar, Mary G. Fowler

Journal Articles: Epidemiology

BACKGROUND: Scale up of paediatric antiretroviral therapy in resource limited settings continues despite limited access to routine laboratory monitoring. We documented the weight and height responses in HIV infected Ugandan children on highly active antiretroviral therapy and determined clinical factors associated with successful treatment outcomes.

METHODS: A prospective cohort of HIV infected children were initiated on HAART and followed for 48 weeks. Body mass index for age z scores(BAZ), weight and height-for-age z scores (WAZ & HAZ) were calculated: CD4 cell % and HIV-1 RNA were measured at baseline and every 12 weeks. Treatment outcomes were classified according to; both …

Adherence To The American College Of Surgeons (Acs) Recommendation On Double Gloving, Hand Free Zone And Blunt Suture Needle Use Among Surgeon Ranks, Akbar Nassiry

Theses and Dissertations

Background: The American College of Surgeons guidelines suggest the use of intact gloves, double gloving, hands-free zone technique to pass sharp instruments, and blunt tip suture needles to protect patients, as well as the surgical team. This study estimates the extent to which these guidelines are followed in a large academic health system. Methods: Over a two-month period in the spring of 2010, 320 general surgical attendings, subspecialty surgical attendings, and surgical resident physicians practicing at a large academic health system, were approached during or after surgical conferences to participate in a cross-sectional study. Nearly 1/3rd completed an anonymous and …

Contextualizing The Health Belief Model And The Social Epidemiology Theories In The Study Of Aids In Malawi, Kumbirai Madondo

All Theses

The association between HIV/AIDS knowledge, risk perception and risky sexual behavior remains a valuable area of study among scholars seeking to understand the AIDS epidemic in Africa. Past research has focused only on either the Health Belief Model or social epidemiology ideas to understand AIDS but never combined the two. The current study is unique and adds to the body of knowledge by making use of both the Health Belief Model and social epidemiology ideas to understand these relationships more clearly and, more importantly, to explore the role that keeping AIDS a secret has in the contexts of risk perception, …