Clinical Epidemiology Commons^™

Comments On The Preliminary Framework For Equitable Allocation Of Covid-19 Vaccine, Ana Santos Rutschman, Julia Barnes-Weise, Robert Gatter, Timothy L. Wiemken

All Faculty Scholarship

On September 1, 2020 the National Academies released a draft framework for Equitable Allocation of a COVID-19 Vaccine. In this response, we analyze the proposed framework and highlight several areas.

Among the proposed changes, we highlight the need for the following interventions. The final framework for distribution of COVID-19 vaccines should give a higher priority to populations made most vulnerable by the social determinants of health. It should incorporate more geography-based approaches in at least some of the four proposed phases of vaccine distribution. It should address the possibility of a vaccine being made available through an emergency use authorization …

Exploring The Hispanic Health Paradox In Mental Health Outcomes: Evidence From The Us-Mexico Border, Laryssa Mykyta, Suad Ghaddar, Leonel Vela

Health & Biomedical Sciences Faculty Publications

Background: Research has established that Hispanic immigrants experience better health outcomes than their US-born counterparts. However, it is unclear whether the immigrant advantage holds for mental health. The purpose of this study is to examine mental health disparities by nativity status in an underserved Hispanic population along the southern border.

Methods: We collected data (N=713, weighted 733,644 adults) in four counties (90% Hispanic) along the Texas-Mexico border from March through August 2018 utilizing a dual-frame sampling design (random-digit dial telephone survey and field survey in randomly-selected colonias). We assessed several mental health outcomes (depression, anxiety, poor mental health …

Is There Less Opioid Abuse In States Where Marijuana Has Been Decriminalized, Either For Medicinal Or Recreational Use? A Clin-Iq, Aaron M. Wendelboe, Richard Mathew, Tana Chongsuwat, Elizabeth Rainwater, Mark A. Wendelboe, Elizabeth Wickersham Md, Ann F. Chou

Journal of Patient-Centered Research and Reviews

Opioid use, abuse, and associated mortality have reached an epidemic level. In some states, cannabis is being used to treat chronic pain. To examine the hypothesis that medical marijuana legislation may reduce adverse opioid-related outcomes if patients substitute cannabis for opioids for pain management, we conducted a clinical inquiry (Clin-IQ). We searched Ovid MEDLINE, Ovid MEDLINE In-Process, and Embase for studies using the search terms marijuana, cannabis, legal, marijuana smoking, medical marijuana, opioid-related disorders, cannabis use, medical cannabis, legal aspect, and opiate addiction. We included population-based articles published from January 1, 2012, through December 5, 2018, that assessed the relationship …

Neighborhood-Level Predictors Of Obesity Among African American Children In California, Uche Onyeka

Journal of Social, Behavioral, and Health Sciences

The increased prevalence of childhood obesity is a major public health concern nationally and globally. Childhood obesity is primarily caused by the imbalance between caloric intake and caloric expenditure; however, its increase over the past decades may be due to environmental and behavioral factors. The purpose of the current study was to examine if any relationships existed between childhood obesity, level of physical activity, and neighborhood-level risk factors. This study used the California Health Interview Survey 2009–2014 data sets for African American children aged 5–11 years (n = 1,049). The dependent variable was body mass index (BMI) while the …

Vitamin Deficiencies Among Resettled Refugees In Buffalo, Ny, Tyler B. Evans, Myron Glick Md

Journal of Refugee & Global Health

Background

Vitamin deficiency in the developing world is a considerable public health issue that is often overlooked. Refugees are some of the most vulnerable populations, since they rely almost exclusively on the nutrition provided by refugee camps. Buffalo, NY resettles the fourth largest number of refugees per capita among cities in the United States (US).

Objective

We examined the prevalence of vitamin A, B2, B12, and D deficiencies among refugees who had been recently resettled to Buffalo, NY and referred to our practice for assessment. Our exploratory objective was to examine potential differences in the prevalence of vitamin deficiencies among …

Syndemics Of Severity And Frequency Of Elder Abuse: A Cross-Sectional Study In Mexican Older Females, Mireya Vilar-Compte, Pablo Gaitán-Rossi

Department of Public Health Scholarship and Creative Works

Background: Elder abuse is a common phenomenon with important effects on the health and well-being of older adults. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency.

Objectives: Identify different ways of measuring severity and frequency of elder abuse and assess whether different experiences of severity and frequency suggest syndemic relationships.

Methods: Through a sample of 534 non-institutionalized Mexican older women, we assessed how severity (i.e., number of abusive experiences and number of types of abuses) and frequency (i.e., if abusive experiences had …

The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer

Dissertations

Purpose: The purpose of this descriptive, qualitative study was to identify and describe the importance of the predictors of juvenile recidivism and the effectiveness of efforts to prevent/avoid juvenile recidivism as perceived by previously detained, arrested, convicted, and/or incarcerated adult students 18 years of age and older exiting from alternative education in Northern California. A second purpose was to explore the types of support provided by alternative schools and the perceived importance of the support to avoid recidivism according to adult students 18 years of age and older exiting from alternative education.

Methodology: This qualitative, descriptive research design identified …

On The “Bubble” Of Burnout's Prevalence Estimates, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi, Laura Hawryluck, Peter G. Brindley

Publications and Research

Hawryluck and Brindley (2018) addressed the issue of burnout—a syndrome thought to be induced by job stress—among critical care medicine (CCM) practitioners. Although we agree that the practice of CCM can be stressful, relying on burnout as an indicator of the practitioners’ response to occupational adversity is unwarranted. Despite its popularity, burnout remains poorly defined. Disconcertingly, investigators have widely relied on the Maslach Burnout Inventory (MBI) for “diagnosing” burnout in spite of the fact that the MBI is not a diagnostic instrument.Experiencing fatigue or distancing oneself from one’ work—what burnout is about—is not necessarily a sign of ill-being in itself. …

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a …

Research Brief: "The National Veteran Sleep Disorder Study: Descriptive Epidemiology And Secular Trends, 2000–2010", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the relation between sleep disorder diagnosis and cardiovascular disease, cancer, and mental health disorders among veterans. In policy and practice, physicians should familiarize themselves with signs of and screenings for sleep disorders and should discuss factors that affect sleep with their veteran patients; the VHA should continue recommending policies that help veterans receive a prompt diagnosis and treatment of their sleep disorders, policymakers should fund early intervention programs to help veterans learn how to cope with reintegration, and the VHA should create a database on sleep disorders in veterans. Suggestions for future research include studying veterans …

The Scoping Review Method: Mapping The Literature In “Structural Change” Public Health Interventions, Rosie Hanneke, Yuka Asada, Lisa D. Lieberman, Leah Christina Neubauer, Michael C. Fagan

Department of Public Health Scholarship and Creative Works

This case discusses how we used scoping review methodology to map the literature in an emergent area of research, “structural change” public health interventions. Scoping reviews are similar to systematic reviews in both scale and rigor; both of these literature review methodologies are comprehensive approaches to reviewing the literature on a topic. However, while a systematic review attempts to answer a specific, targeted research question, a scoping review is designed to map and categorize all of the literature on a broad topic. For this reason, it is an excellent method to employ in emergent research areas, in which researchers have …

‘Burnout Syndrome’: From Nosological Indeterminacy To Epidemiological Nonsense, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

All in all, Imo’s review is undermined by the very research it relies on. We recommend that researchers interested in burnout begin at the beginning, that is to say, by establishing a reasoned, clinically-founded (differential) diagnosis for their entity of interest. As long as investigators do not complete the required groundwork for establishing a diagnosis and remain unable to distinguish a case of burnout from either a noncase or an existing disorder, conclusions regarding the prevalence of burnout will be nonsense. To close this comment, we note that an immediately available solution for effectively monitoring and protecting physicians’ occupational health …

Consequences Of Job Stress For The Psychological Well-Being Of Teachers, Irvin Sam Schonfeld, Renzo Bianchi, Peter Luehring-Jones

Publications and Research

This chapter examines research on the relationship between job stressors and mental health (depressive symptoms, burnout, and mental disorders such as depression) in teachers. Teachers are exposed daily to job stressors (e.g., student disruptiveness) that have been linked to adverse mental health effects. Epidemiologic research indicates that when compared to members of other groups, teachers experience higher rates of mental disorder, although some studies question that conclusion. Large-scale studies indicate when compared to members of other occupational groups, teachers are at higher risk for exposure to workplace violence, with its adverse mental health consequences. Longitudinal research has linked teaching-related stressors …

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …

Detroit Health Department: Lead Report 2016, Abdul El-Sayed, Alex B. Hill, Haifa Haroon

Urban Studies and Planning Faculty Research Publications

The Epidemiology team at the Detroit Health Department rigorously stress- tested Detroit’s lead numbers. The findings suggest a true decline in EBLL levels rather than a decrease in lead testing or a change in the characteristics of the children who are being tested.

Symptom Patterns Of Posttraumatic Stress Disorder Among Deaf Trauma Survivors, Melissa L. Anderson, Amanda Sortwell, Kelly S. Wolf Craig, Douglas M. Ziedonis

JADARA

Details about Deaf people’s pattern of posttraumatic stress disorder (PTSD) symptoms remain relatively unknown due to inaccessible methods used in most epidemiological research. We conducted semi-structured American Sign Language interviews with 16 trauma-exposed Deaf individuals to explore their PTSD symptom patterns. Half met criteria for current PTSD, a rate higher than the general population. Underlying this disparity may be heightened rates of dissociation and psychogenic amnesia reported by many Deaf trauma survivors. Future research with large samples of Deaf survivors is needed to clarify this hypothesis, and to inform interventions that more accurately target Deaf people’s pattern of trauma symptoms.

Adolescent Attitudes Toward And Perceptions Of Suicide, Stigma, And Help-Seeking Behavior, Julia M. Hollinger

PCOM Psychology Dissertations

Suicide is a leading cause of death for adolescents and represents a major national health concern (American Foundation for Suicide Prevention, [AFSP], 2015; (Centers for Disease Control [CDC], 2013). Because adolescents spend the majority of their day at school (Erbacher, Singer, & Poland, 2015), the effectiveness of school-based suicide prevention programs may be improved through better understanding of adolescents’ views on the subject of suicide and the factors that may influence participation in prevention efforts. The present study explored the attitudes and perceptions of seventh grade students from a suburban middle school in Pennsylvania, using archival survey data. Variables that …

Economic Evaluation Of Fungal Meningitis Outbreak Response In New River Valley: Local Health Department Perspective, Kaja M. Abbas, Nargesalsadat Dorratoltaj, Margaret L. O’Dell, Paige Bordwine, Thomas M. Kerkering, Kerry J. Redican

Frontiers in Public Health Services and Systems Research

Background: The multi-state fungal meningitis outbreak started in September 2012 in Tennessee. The cause of the outbreak was injection of contaminated lots of methylprednisolone acetate used in epidural spinal injections. Roanoke and New River Valley were the epicenter of this outbreak in Virginia, with two clinical centers having administered the contaminated injections to their patients. New River Health District, in coordination with hospitals, and state and federal agencies, deployed its resources to control the local impact of the outbreak.

Purpose: The objective of this study was to conduct an economic evaluation of the fungal meningitis outbreak response in New River …

Know Your Status: Alleviating Stigma From The Hiv Positive Community Of San Luis Obispo California, Mario Alberto Viveros Espinoza

Ethnic Studies

The purpose of this project is to alleviate stigma from the HIV community in San Luis Obispo, CA by creating an outreach program, “Know Your Status,” that raises awareness of HIV education and prevention. Research on HIV stigma and on ideologies for program development and implementation shows that HIV positive individuals face both internalized and externalized stigma. Program development and implementation can be effective by assessing and addressing the specific needs of those living within the community. This project includes the data needed for program development and implementation, collected through anonymous surveys from HIV positive community members, interviews with professionals …

Who Done It? Rurality Vs. Ses As Critical Factors In Evaluating The Prevalence Of Child Psychosocial Concerns In Primary Care, Robert M. Tolliver

Electronic Theses and Dissertations

The purpose of this study was to evaluate the prevalence of child psychosocial concerns in rural primary care, hypothesized to be greater than national averages due to lacking mental health services in rural areas. This study was an examination of the role of SES, various definitions of “rural,” and the interaction of SES and rurality, in predicting parent-reported child psychosocial concerns in Appalachian primary care clinics. Caregivers presenting with their child at one of 8 pediatric primary care sites (n=2,672) were recruited to complete a measure assessing demographics and the Pediatric Symptom Checklist (PSC). Results showed that while rural status …

Empowerment-Based Positive Youth Development: A New Understanding Of Healthy Development For African American Youth, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

A shift occurred in research about adolescents in the general population. Research is moving away from deficits toward a resilience paradigm and understanding trajectories of positive youth development. This shift has been less consistent in research and practice with African American youth. A gap also exists in understanding whether individual youth development dimensions generate potential in other dimensions. This study presents an empowerment-based positive youth development model. It builds upon existing research to present a new vision of healthy development for African American youth that is strengths-based, developmental, culture-bound, and action-oriented. It emphasizes the relationship between person and environment, the …

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 …

Social And Behavioral Sti Risk Factors: Comparing A Two-Year Community College Setting To A Four-Year University Setting, Oswald M. Attin

Faculty Publications and Presentations

No abstract provided.

Research Brief: An Examination Of The Social And Clinical Influences In Prostate Cancer Treatment In African American And White Men, Keith Elder, Bettina F. Drake, Sara Wagner, James Hebert

Journal of Health Disparities Research and Practice

BACKGROUND: The death rate for prostate cancer (PrCA), the most commonly diagnosed cancer in African-American (AA) men, is twice the rate of European-American (EA) men. AA men in South Carolina have the highest age-adjusted death rate in the nation. Studies have shown that treatment offered to AA men with PrCA is systematically different from that offered to EA men. METHODS: Surveys were mailed to 1,866 men in South Carolina with a diagnosis of PrCA. South Carolina men diagnosed with PrCA between 1996 and 2002 were eligible to participate. We performed a descriptive assessment of the factors that influenced …

Book Review: Dream Of Ding Village By Yan Lianke, Mike Frick

China Beat Blog: Archive 2008-2012

Unsurprisingly, the Chinese government levied a “three nos” ban—no sales, no distribution, and no promotion—against Dream of Ding Village after its publication in 2005. Though the storytelling relies heavily on dream sequences, Yan takes little poetic license when exposing the depth of the state’s culpability in spreading HIV among poor, medically-naïve farmers. He is just as uncompromising when detailing how officials denied responsibility for the ensuing AIDS epidemic, even as they profited from its human tragedy. No one in Ding Village receives medical care, mental health counseling, food assistance, or a chance to hold the blood heads legally accountable. Cast …

Comparing Risk Factors Of Hiv Among Hijra Sex Workers In Larkana And Other Cities Of Pakistan: An Analytical Cross Sectional Study, Arshad Altaf, Aysha Zahidie, Ajmal Agha

Community Health Sciences

Background

In 2005, Pakistan was first labeled as a country with concentrated epidemic of Human Immunodeficiency Virus (HIV). This was revealed through second generation surveillance conducted by HIV/AIDS Surveillance Project (HASP). While injection drug users (IDUs) were driving the epidemic, subsequent surveys showed that Hijra (transgender) sex workers (HSWs) were emerging as the second most vulnerable group with an average national prevalence of 6.4%. An exceptionally high prevalence (27.6%) was found in Larkana, which is a small town on the right bank of river Indus near the ruins of Mohenjo-Daro in the province of Sindh. This paper presents the risk …

Race And Hepatitis C Management Within The Veterans Administration, Joahd Toure, Joshua Metlay, Sandford Schwartz, Knashawn Morales, David Kaplan, Peter Groeneveld

Journal of Health Disparities Research and Practice

Objective: To examine black-white differences in hepatitis C treatment within the Veterans Administration (VA) and determine whether racial variation in specialty consultation explains differences in hepatitis C treatment between blacks and whites.

Methods: We performed a retrospective cohort study of 1040 veterans meeting VA eligibility criteria for hepatitis C treatment. We used multiple imputation to handle missing race data. Specialty consultation was determined from the VA outpatient medical dataset and hepatitis C treatment was determined from the VA decision support system. Conditional logistic regression was used to examine the association between race and hepatitis C treatment as well as race …

Health Communication Theories: Implications For Hiv Reporting In Asia And The Pacific, Trevor Cullen

Research outputs pre 2011

This paper focuses on the expanding HIV (Human Immunodeficiency Virus) epidemic in parts of Asia and the Pacific region and recommends the adoption of insights from particular health communication theories. The author argues that these paradigms can assist in broadening the current scope and content of HIV reporting. One theory in particular - Social Change Communication (SCC) - challenges the media to extend the framing of HIV from primarily a health story to one that is linked to more macro socio-economic, cultural and political factors. Asian and Pacific countries that have an emerging or expanding HIV epidemic need to realise …

Psychological Distress And Change In A Pediatric Obesity Population, Amy Rebecca Beck

Loma Linda University Electronic Theses, Dissertations & Projects

Pediatric overweight and obesity is a growing national epidemic with 15 percent of children ages 6-19 considered obese and at least 22 percent considered overweight. While there is considerable research pointing to contributing factors of obesity, there is a paucity of research which elucidates what contributes to successful intervention. Considering that by the year 2050, nearly 50 million Americans may be obese, understanding the factors delineating success of weight loss and prevention is a necessity. The purpose of this study was to utilize archival data from the LLU Growing Fit Program to evaluate the levels of psychological distress experienced by …

Recently Arrested Adolescents Are At High Risk For Sexually Transmitted Diseases, Steven Belenko, Richard Dembo, Doris Weiland, Matthew Rollie, Christopher Salvatore, Alexandra Hanlon, Kristina Childs

Department of Justice Studies Faculty Scholarship and Creative Works

Adolescent offenders may be at high risk for sexually transmitted diseases (STDs). With previous research and interventions focused on incarcerated adolescents, data are needed on STD prevalence and risk factors among newly arrested youth released to the community, a far larger subgroup.Participants were recruited from all arrested youth processed at the Hillsborough County, Florida Juvenile Assessment Center during the last half of 2006 (506 males, 442 females). Participants voluntarily providing urine samples for drug testing as part of standard protocol were also consented to having their specimens split and tested for chlamydia and gonorrhea, using an FDA-approved nucleic acid amplification …