Public Health Commons^™

Factors Associated With Tuberculin Skin Test Positivity Prevalence In U.S. Medical Laboratory Microbiologists, Julie Ann West

Walden Dissertations and Doctoral Studies

Prior research has indicated that healthcare personnel (HCP) who work in areas where Mycobacterium tuberculosis poses an occupational hazard are at high risk of tuberculin skin test (TST) positivity and subsequent conversion to active tuberculosis (TB). U.S. medical laboratory microbiologists confront similar hazards but have not been studied outside of the HCP aggregate. The purpose of this study was to fill this gap by examining the relationships between the predictor variables of self-reported history of bacille Calmette-Guerin (BCG) immunization, place of birth, and years of laboratory experience and the outcomes of self-reported lifetime TST positivity, preventive treatment noninitiation, and barriers …

Relationship Between Altitude And Lithium In Groundwater In The United States Of America: Results Of A 1992–2003 Study, Rebekah S. Huber, Namkug Kim, Carl E. Renshaw, Perry F. Renshaw, Douglas Kondo

Dartmouth Scholarship

Therapeutic dosages of lithium are known to reduce suicide rates, which has led to investigations of confounding environmental risk factors for suicide such as lithium in groundwater. It has been speculated that this might play a role in the potential relationship between suicide and altitude. A recent study in Austria involving geospatial analysis of lithium in groundwater and suicide found lower levels of lithium at higher altitudes. Since there is no reason to suspect this correlation is universal given variation in geology, the current study set out to investigate the relationship between altitude and lithium in groundwater in the United …

Exploration Of The Genetic Epidemiology Of Asthma: A Review, With A Focus On Prevalence In Children And Adolescents In The Caribbean, A. Mohan, A. J. Roberto, B. C. Whitehill, A. Mohan, A. Kumar

Biological Sciences Faculty Publications

Asthma is a chronic disease caused by the inflammation of the main air passages of the lungs. This paper outlines a review of the published literature on asthma. While a few studies show a trend of rising asthma cases in the Caribbean region, even fewer have explored the genetic epidemiological factors of asthma. This is a literature review that seeks to sum the body of knowledge on the epidemiology of asthma. Specifically, the major objective of the literature review is to provide a unified information base on the current state of factors involved in the genetic epidemiology of asthma. The …

Proximate And Evolutionary Insights Into The Epigenetics Of Posttraumatic Stress Disorder, Levent Sipahi

Wayne State University Dissertations

Posttraumatic stress disorder (PTSD) is an important medical and social condition. Although the vast majority of individuals are exposed to traumatic events within their lifetime, a minority subsequently develop diagnosable PTSD. What underlies differential risk and resiliency in the face of trauma is an ongoing research and clinical question with implications for prevention and treatment. Recent work has revealed a putative role of epigenetic variation and modification - most notably DNA methylation - in the etiology of PTSD. That DNA methylation is stable, yet modifiable in response to lived experiences, makes it a strong candidate to mechanistically explain the ontogeny …

Finding Them Before They Find Us: Informatics, Parasites, And Environments In Accelerating Climate Change, Daniel R. Brooks, Eric P. Hoberg, Walter A. Boeger, Scott Lyell Gardner, Kurt E. Galbreath, David Herczeg, Hugo H. Mejía-Madrid, S. Elizabeth Rácz, Altangerel Tsogtsaikhan Dursahinhan

Harold W. Manter Laboratory of Parasitology: Faculty Publications

Parasites are agents of disease in humans, livestock, crops, and wildlife and are powerful representations of the ecological and historical context of the diseases they cause. Recognizing a nexus of professional opportunities and global public need, we gathered at the Cedar Point Biological Station of the University of Nebraska in September 2012 to formulate a cooperative and broad platform for providing essential information about the evolution, ecology, and epidemiology of parasites across host groups, parasite groups, geographical regions, and ecosystem types. A general protocol, documentation–assessment–monitoring–action (DAMA), suggests an integrated proposal to build a proactive capacity to understand, anticipate, and respond …

The Sociocultural Basis Of Epidemiology Of Hypertension Among Residents Of Ogun State, Vernon E. Norman

Walden Dissertations and Doctoral Studies

There is a high prevalence of hypertension in Nigeria. Limited knowledge of hypertension, how to prevent it, its outcomes, rapid urbanization, and the adoption of Western eating habits are implicated. Hypertension is an important issue because chronic disease places economic, social, and disease burdens on society. The purpose of this mixed-methods study was to investigate lifestyle practices, knowledge, and attitudes on risks and prevention of hypertension among residents of Ogun State, Nigeria (N = 79). The conceptual framework for this study focused on how knowledge, attitudes, and practices influence the dietary habits, behaviors, and ultimately blood pressure . The PEN-3 …

Gestational Weight Gain And The Risk Of Obesity Among Preschool Children: Is This Mediated Through Birth Weight?, Nomathamsanqa Louise Mgutshini

Theses and Dissertations

Data from the 2001 Early Childhood Longitudinal Study Birth- Cohort were used to examine the association between maternal gestational weight gain (GWG) and the risk of obesity in the offspring, and the possible mediating role of birth weight. The Centers for Disease Control growth 2000 reference charts and child's height and weight measured at age 4 or 5 years old were used to determine child body mass index (BMI) Z-scores or obesity status (greater than or equal to the 95th percentile). Multiple linear or logistic regression models were used to adjust for maternal age, race, education, smoking status and prepregnancy …

The Effect Of Marriage On Stage At Diagnosis And Survival In Women With Cervical Cancer, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Marriage is associated with improved health outcomes for many conditions. Married persons enjoy financial stability, social and emotional support, and tend to have better control of health risk behaviors compared to the unmarried. The marriage scene is changing continuously. Americans are marrying less or delaying the engagement to an older age. They are divorcing more, they choose cohabitation as an alternative to marriage, or engage in premarital relationships. As a consequence, barely half of Americans were married in 2011 compared to close to three quarters of Americans were married in the sixties. With the increase of the unmarried population - …

Asthma And Risk Of Non-Respiratory Tract Infection: A Population-Based Case-Control Study, Duk Won Bang, Hyeon J Yang, Eell Ryoo, Majdi N. Al-Hasan, Brian Lahr, Larry M. Baddour, Barbara P. Yawn, Young J. Juhn

Internal Medicine Faculty Publications

OBJECTIVES: Asthmatics have increased risks of airway-related infections. Little is known about whether this is true for non-airway-related serious infections such as Escherichia coli bloodstream infection (BSI). We assessed whether asthma is associated with a risk of developing community-acquired E coli BSI.

DESIGN: The study was designed as a population-based retrospective case-control study.

SETTING: This population-based study was conducted in Olmsted County, Minnesota.

PARTICIPANTS: The study included 259 all eligible community-acquired E coli BSI cases in Olmsted County, MN between 1998 and 2007 and 259 birthday-matched, gender-matched and residency-matched controls.

PRIMARY AND SECONDARY OUTCOME MEASURES: Only community-acquired E coli BSI …

Mapping Disease At An Approximated Individual Level Using Aggregate Data: A Case Study Of Mapping New Hampshire Birth Defects, Xun Shi, Stephanie Miller, Kevin Mwenda, Akikazu Onda

Dartmouth Scholarship

Limited by data availability, most disease maps in the literature are for relatively large and subjectively-defined areal units, which are subject to problems associated with polygon maps. High resolution maps based on objective spatial units are needed to more precisely detect associations between disease and environmental factors. Method: We propose to use a Restricted and Controlled Monte Carlo (RCMC) process to disaggregate polygon-level location data to achieve mapping aggregate data at an approximated individual level. RCMC assigns a random point location to a polygon-level location, in which the randomization is restricted by the polygon and controlled by the background (e.g., …

Shared Learning In An Interconnected World: Innovations To Advance Global Health Equity, Agnes Binagwaho, Cameron T. Nutt, Vincent Mutabazi, Corine Karema

Dartmouth Scholarship

The notion of "reverse innovation"--that some insights from low-income countries might offer transferable lessons for wealthier contexts--is increasingly common in the global health and business strategy literature. Yet the perspectives of researchers and policymakers in settings where these innovations are developed have been largely absent from the discussion to date. In this Commentary, we present examples of programmatic, technological, and research-based innovations from Rwanda, and offer reflections on how the global health community might leverage innovative partnerships for shared learning and improved health outcomes in all countries.

Sessile Serrated Adenomas In The Proximal Colon Are Likely To Be Flat, Large And Occur In Smokers, Tarun Rustagi, Priya Rangasamy, Matthew Myers, Melinda Sanders, Haleh Vaziri, George Y. Wu, John W. Birk, Petr Protiva, Joseph C. Anderson

Dartmouth Scholarship

Aim: To examine the epidemiology and the morphology of the proximal sessile serrated adenomas (SSAs).

Methods: We conducted a retrospective study to identify patients with SSAs using a university-based hospital pathology database query from January 2007 to April 2011. Data collected included: age, gender, ethnicity, body mass index, diabetes, smoking, family history of colorectal cancer, aspirin, and statin use. We collected data on morphology of SSAs including site (proximal or distal), size, and endoscopic appearance (flat or protuberant). We also compared proximal SSAs to proximal tubular adenomas detected during same time period.

Net Reclassification Indices For Evaluating Risk Prediction Instruments: A Critical Review, Kathleen F. Kerr, Zheyu Wang, Holly Janes, Robyn Mcclelland, Bruce M. Psaty, Margaret S. Pepe

UW Biostatistics Working Paper Series

Background Net Reclassification Indices (NRI) have recently become popular statistics for measuring the prediction increment of new biomarkers.

Methods In this review, we examine the various types of NRI statistics and their correct interpretations. We evaluate the advantages and disadvantages of the NRI approach. For pre-defined risk categories, we relate NRI to existing measures of the prediction increment. We also consider statistical methodology for constructing confidence intervals for NRI statistics and evaluate the merits of NRI-based hypothesis testing.

Conclusions Investigators using NRI statistics should report them separately for events (cases) and nonevents (controls). When there are two risk categories, the …

Systematic Examination Of Infant Size And Growth Metrics As Risk Factors For Overweight In Young Adulthood, Andrew O. Odegaard, Audrey C. Choh, Ramzi W. Nahhas, Bradford Towne, Stefan A. Czerwinski, Ellen W. Demerath

Population and Public Health Sciences Faculty Publications

Objective:To systematically examine infant size and growth, according to the 2006 WHO infant growth standards, as risk factors for overweight status in young adulthood in a historical cohort. Specifically, to assess: Whether accounting for length (weight-for-length) provides a different picture of risk than weight-for-age, intervals of rapid growth in both weight-for-age and weight-for-length metrics, and what particular target ages for infant size and intervals of rapid growth associate most strongly with overweight as a young adult.Patients/Methods:Data analysis of 422 appropriate for gestational age white singleton infants enrolled in the Fels Longitudinal Study. Odds ratios (OR) for overweight and obesity in …

Maximizing The Delivery Performance Of Point-Of-Care Cd4+ T-Cell Counting Tests In Resource-Limited Settings - A Policy Brief, Nan Kong, J. Paul Robinson, Fenggang Yang

Purdue Policy Research Institute (PPRI) Policy Briefs

Managing HIV/AIDS presents challenges to public health policymakers, frontline workers, and researchers worldwide. A key strategy in the disease management is early diagnosis and rapid treatment initiation. While the technological field of point‐of‐care HIV/AIDS diagnostics has advanced significantly in the past two decades, several critical issues remain that hinder the deployment of point‐of‐care testing devices in resource‐deprived settings. In this policy brief, we discuss these issues, including technological specifics of point‐of‐care CD4⁺ T‐cell counting approaches and requirements of deploying them. We also discuss cultural and religious concerns on the deployment. At the end of the brief, we propose a …

National Estimates Of Emergency Department Visits For Pediatric Severe Sepsis In The United States, Sara Singhal, Mathias W. Allen, John-Ryan Mcannally, Kenneth S. Smith, John P. Donnelly, Henry E. Wang

Emergency Medicine Faculty Publications

Objective. We sought to determine the characteristics of children presenting to United States (US) Emergency Departments (ED) with severe sepsis.

Study design. Cross-sectional analysis using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS). Using triage vital signs and ED diagnoses (defined by the International Classification of Diseases, Ninth Revision codes), we identified children(triage fever or ICD-9 infection) and organ dysfunction (triage hypotension or ICD-9 organ dysfunction).

Results. Of 28.2 million pediatric patients presenting to US EDs each year, severe sepsis was present in 95,055 (0.34%; 95% CI: 0.29-0.39%). Fever and respiratory infection were the most common indicators of …

When Pictures Waste A Thousand Words: Analysis Of The 2009 H1n1 Pandemic On Television News, Westerly Luth, Cindy Jardine, Tania M. Bubela

Office of the Provost

Objectives: Effective communication by public health agencies during a pandemic promotes the adoption of recommended health behaviours. However, more information is not always the solution. Rather, attention must be paid to how information is communicated. Our study examines the television news, which combines video and audio content. We analyse (1) the content of television news about the H1N1 pandemic and vaccination campaign in Alberta, Canada; (2) the extent to which television news content conveyed key public health agency messages; (3) the extent of discrepancies in audio versus visual content.
Methods: We searched for "swine flu" and "H1N1" in local English …

Observational Intensity Bias Associated With Illness Adjustment: Cross Sectional Analysis Of Insurance Claims, J. E. Wennberg, D. O. Staiger, S. M. Sharp, D. J. Gottlieb

Dartmouth Scholarship

Objective: To determine the bias associated with frequency of visits by physicians in adjusting for illness, using diagnoses recorded in administrative databases.

Setting: Claims data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions.

Design: Cross sectional analysis. Participants 20% sample of fee for service Medicare beneficiaries residing in the United States in 2007 (n=5 153 877).

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 …

High Density Genotyping For Immunogenetic Polymorphisms Associated With Transmission And Control Of Hiv-1 Infection In Zambian Heterosexual Serodiscordant Couples, Heather Prentice

All ETDs from UAB

Understanding host genetic correlates of HIV-1 outcomes in sub-Saharan African populations is of continued importance due to the disproportionate disease burden in this population. We sought to identify genetic variants associated with HIV-1 acquisition in a sample of 439 initially seronegative individuals enrolled in the Zambia-Emory HIV Research Project, as well as novel variants associated with viral load (VL) in a sample of 172 seroconverters (SCs) with an estimated date of infection and 449 seroprevalent individuals (SPs). We were unable to detect any statistically significant associations in our analysis of HIV-1 acquisition, though one signal in the HLA-DOA gene associated …

Investigating Developmental Patterns Of Symptom And Impairment Change Among Youth With Adhd, Subthreshold Adhdand Youth Without Adhd, Lorie Love Geryk

Theses and Dissertations

Introduction. Despite a substantial prevalence of subthreshold Attention-Deficit/Hyperactivity Disorder (ADHD) and research indicating that many youth with this disorder have impaired functioning and negative outcomes, few studies have considered patterns of symptom and functioning change for youth with probable ADHD, subthreshold ADHD and youth without ADHD transitioning from childhood to adolescence. Additionally, we are not aware of any studies examining predictors of impairment severity among youth with subthreshold ADHD, and few studies have examined predictors of treatment utilization and patterns of symptom and functioning change based on medication status for youth with subthreshold ADHD compared to youth with ADHD. Methods. …

Using Box-Jenkins Modeling Techniques To Forecast Future Disease Burden And Identify Disease Aberrations In Public Health Surveillance Report, Larry C. Garrett

Dissertations

The analysis of public health surveillance data to identify departures from historical patterns of disease is required to facilitate the timely identification of potential outbreaks. Using the Box-Jenkins forecasting model, this study examines the potential to predict future disease burden based upon the historical record within local public health jurisdictions. Box-Jenkins forecasting was developed as a direct result of forecast problems in the business, economic, and control-engineering applications, yet it has not been systematically examined for use with public heath surveillance data.

Box-Jenkins forecast models are constructed by stratifying 84,029 disease reports from the State of Utah by year (n …

The Effectiveness Of Health Education Materials In Influencing Hiv Testing Behavior: The Unlv-Siphi Study, Rebecca Tsegay

UNLV Theses, Dissertations, Professional Papers, and Capstones

The UNLV-SIPHI (Sexual Health Internet-Based Public Health Intervention) Study focused on HIV prevention by improving HIV testing behavior through the development and dissemination of health education materials. The goal of the UNLV-SIPHI Study was to develop effective, custom-made HIV health education materials that promote the knowledge, intention and practice of HIV testing among UNLV students. The UNLV-SIPHI Study was conducted during Spring 2012 semester in selected UNLV undergraduate classes. An online quasi-randomized-control trial (RCT) was used to measure the difference in HIV testing behavior contributing factors among students exposed to the health education materials. Several nonparametric tests were used to …

The Administrative Prevalence Of Autism Spectrum Disorders In Nevada School Districts: A Pooled Time Series Analysis, 1996-2004, John P. Tuman, Sheniz Moonie, Danielle Roth-Johnson

Nevada Journal of Public Health

Objective: To examine the administrative prevalence of Autism Spectrum Disorders (ASD) in all seventeen school districts in Nevada during the period of 1996 to 2004.

Methods: Normalized administrative prevalence rates (per 1,000 children ages 6-17) for ASD, Mental Retardation (MR), Learning Disability (LD), and Speech and Language Impairment (SLI) were calculated. Covariates for board certified pediatricians per 1,000 students, Federal special education funding per student, and other measures of school resources were employed. Models were estimated with pooled Ordinary Least Squares (OLS) regression with panel corrected standard errors. A separate analysis compared pooled OLS results to results from Latent Growth …

Curated Exhibit 100 Years: Celebrating New Mexico's Health, Laura J. Hall

Posters and Presentations

In celebration of New Mexico's centennial year, the 100 Years: Celebrating New Mexico's Health exhibit documented major health advancements and themes from the state's first century of statehood. Curated by Laura J. Hall, MFA, the exhibit was on display from 2012 to 2013 at the UNM Health Sciences Center. It showcased the evolution of public health in New Mexico, from early challenges such as tuberculosis and high infant mortality rates, to modern advances in epidemiology, maternal care, and biomedical research. Accompanied by films, lectures, and weekly stories from the archives, the exhibit highlighted the contributions of health professionals to the …

Epidemiology Of Tuberculosis In Ohio, Usha Bala Vayuvegula

Master of Public Health Program Student Publications

Background: Tuberculosis (TB) is a global infectious disease often associated with HIV. Study of the distribution and epidemiologic trends may help target prevention and control measures towards high risk areas and groups.

Objective: To determine TB trends in four counties in Ohio, i.e. Franklin, Cuyahoga, Hamilton and Montgomery counties, and to explore differences in distribution of cases across gender, age groups and races.

Methods: TB surveillance data was collected from the Ohio Department of Health website for 12 years (1999-2011). Mean TB rates across gender were compared using the two sample t-test. One way ANOVA was used to compare means …

Measuring Infertility In Populations: Constructing A Standard Definition For Use With Demographic And Reproductive Health Surveys, Maya N. Mascarenhas, Hoiwan Cheung, Colin D. Mathers, Gretchen A. Stevens

Dartmouth Scholarship

Background: Infertility is a significant disability, yet there are no reliable estimates of its global prevalence. Studies on infertility prevalence define the condition inconsistently, rendering the comparison of studies or quantitative summaries of the literature difficult. This study analyzed key components of infertility to develop a definition that can be consistently applied to globally available household survey data.

Methods: We proposed a standard definition of infertility and used it to generate prevalence estimates using 53 Demographic and Health Surveys (DHS). The analysis was restricted to the subset of DHS that contained detailed fertility information collected through the reproductive health calendar. …

Refining The Global Spatial Limits Of Dengue Virus Transmission By Evidence-Based Consensus, Oliver J. Brady, Peter W. Gething, Samir Bhatt, Jane P. Messina, John S. Brownstein, Anne G. Hoen

Dartmouth Scholarship

Background: Dengue is a growing problem both in its geographical spread and in its intensity, and yet current global distribution remains highly uncertain. Challenges in diagnosis and diagnostic methods as well as highly variable national health systems mean no single data source can reliably estimate the distribution of this disease. As such, there is a lack of agreement on national dengue status among international health organisations. Here we bring together all available information on dengue occurrence using a novel approach to produce an evidence consensus map of the disease range that highlights nations with an uncertain dengue status.

Methods/Principle Findings: …

A Geographical Analysis Of Hiv/Aids Infection In Nigeria, 1991-2001, Chinekwu Azuka Obidoa, Robert G. Cromley

Journal of Social, Behavioral, and Health Sciences

Abstract

Objectives: Within the gradually accumulating literature on the Acquired Immune Deficiency Syndrome (AIDS) in Nigeria, investigations concerning the spatial dimensions of the infection are virtually non-existent. An understanding of the spatial dimensions of the epidemic is central in the development and implementation of appropriate intervention strategies. This study is a geographic analysis of HIV/AIDS infection in Nigeria from 1991 – 2001. The three objectives of this study were: 1) to examine the geographic pattern of the epidemic, 2) to examine the spatial-temporal trend and diffusion pattern of the epidemic, and 3) to explore the factors associated with the spatial …

Two Boundaries Separate Borrelia Burgdorferi Populations In North America, Gabriele Margos, Jean I. Tsao, Santiago Castillo-Ramirez, Yvette A. Girard, Anne G. Hoen

Dartmouth Scholarship

Understanding the spread of infectious diseases is crucial for implementing effective control measures. For this, it is important to obtain information on the contemporary population structure of a disease agent and to infer the evolutionary processes that may have shaped it. Here, we investigate on a continental scale the population structure of Borrelia burgdorferi, the causative agent of Lyme borreliosis (LB), a tick-borne disease, in North America. We test the hypothesis that the observed d population structure is congruent with recent population expansions and that these were preceded by bottlenecks mostly likely caused by the near extirpation in the 1900s …