Clinical Epidemiology Commons^™

Cross Cultural Adaptation And Validation Of A Self-Reporting Tool To Assess Health-Related Quality Of Life For Egyptians With Extremity Bone Sarcomas In Childhood Or Adolescence, Nesma Farid

Theses and Dissertations

Validated self-reporting tools are required to evaluate the functional outcome and health-related quality of life (HRQOL) for Egyptians who had extremity bone sarcomas in their childhood or adolescence. Thus, we pursued cross-cultural adaptation and validation of the pediatric Toronto Extremity Salvage Score (pTESS) and Toronto Extremity Salvage Score (TESS) to assess the physical function of children and adult survivors following surgeries of extremity bone sarcomas. Modified versions of pTESS and TESS, which contain additional mental domains, were developed to allow the evaluation of HRQOL using a specific instrument for childhood bone cancer. The internal consistency of the original pTESS and …

Access To Hiv Prevention, Care, And Treatment Services In The Us: The Role Of Primary Care, Jessica S. Kiernan

Theses and Dissertations

This dissertation examines the role of access to primary care in benefitting HIV outcomes through increased access to HIV prevention, care, and treatment services, among populations disproportionately affected by HIV in the US. Over 30,000 individuals are newly diagnosed with HIV annually in the US and diagnoses are concentrated in specific populations. At an individual-level, ~ 70% of new diagnoses are among gay and bisexual men and of those diagnoses, 70% are among Non-Hispanic Black and Hispanic gay and bisexual men. At a community-level, over 50% of new HIV diagnoses occur in less than 2% of US counties (48), Washington, …

Identifying Micrornas Panel Associated With Hepatocellular Carcinoma In Serum Of Chronic Hepatitis C Patients, Areeg Dabbish

Theses and Dissertations

Introduction: early detection of hepatocellular carcinoma (HCC) will reduce morbidity and mortality rates of this poorly diagnosed widely-spread disease. Dysregulation in microRNA (miRNAs) expression is associated with HCC progression. Objective: Is to identify a panel of differentially expressed miRNAs (DE-miRNAs) to enhance HCC early prediction in hepatitis C virus (HCV) infected patients. Methodology: Candidate miRNAs were selected using bioinformatic analysis of microarray and RNA-sequencing datasets, resulting in nine DE- miRNAs (miR-142, miR-150, miR-183, miR-199a, miR-215, miR-217, miR-224, miR-424 and miR-3607). Their expressions were validated in the serum of 44 healthy individuals, 62 non-cirrhotic HCV patients, 67 cirrhotic-HCV and 72 HCV-associated …

Another Step In Diagnostics Consultation Model© Actualization: Examining The Impact Of Consultation Workflow Processes On Providers' Clinical Decision Making, Elizabeth K. Leibach

Theses and Dissertations

Background
Communication errors in health services delivery significantly compromise quality in clinical decision making (CDM). Diagnostic information generated by clinical laboratories (CL) accounts for as much as 93% of objective data in the clinical record and therefore is foundational in CDM. This work describes the Diagnostics Consultation Model© (DCM©), a CL communications portal, which supports CDM within interprofessional teams, providers, and institutions. Specific aims were to develop and validate a workflow prediction index (the complexity index, CI) to assign resolution of consultation requests based on an algorithm comprised of characteristics available at the point of consultation initiation. The CI functions …

An Examination Between Neighborhood Characteristics And Alzheimer’S Disease And Related Dementias And Caregiver Mental Health In South Carolina, Dana Mahmoud Alhasan

Theses and Dissertations

Research has examined the relationship between neighborhood environments and cognitive decline, yet few have investigated the role of neighborhood characteristics specifically on incident Alzheimer’s disease and related dementias (ADRD), on severity of Alzheimer’s disease (AD) including neuropsychiatric symptoms (NPS), and on caregiver mental health including depressive symptoms. This dissertation aimed to 1) ecologically examine the geographic distribution of ADRD and investigate ecologic associations between census-tract neighborhood characteristics and diagnosed ADRD case incidence from 2010-2014 in the South Carolina (SC) Alzheimer’s Disease Registry; 2) estimate the cross-sectional association between neighborhood characteristics and NPS among those with AD in 2010 in SC; …

The Interaction Between Caffeine Consumption, Alcohol Use, And Amount Of Sleep On Bone Health, Haley Davis-Martin

Theses and Dissertations

Using cross-sectional data from the 2009-2010 and 2013-2014 NHANES surveys we examined potential interaction between caffeine consumption, alcohol use, and sleep and its relation to bone health, measured using bone mineral density (BMD). The study population consisted of 2,405 individuals at least 40 years old who were not taking any medications or hormones that would affect bone mineral density. Several factors such as smoking status, exercise, dietary intake of calcium, dietary intake of vitamin D, dietary intake of phosphorus, presence of arthritis, age, gender and race were considered in this project. We found a statistically significant negative linear relationships between …

The Impact Of Psychosocial, Clinical, And Neighborhood Factors On Inflammatory Outcomes Among African American Women, Malcolm Seth Bevel

Theses and Dissertations

Inflammatory-related chronic diseases are disparagingly prevalent among African Americans in the United States, particularly in the Southeastern region. Access to community gardens shows promise in mitigating chronic disease outcomes, despite multiple barriers to physical activity and diet among underserved populations. We seek to determine if psychosocial or clinical factors mediate the association between the treatment effect of a healthy lifestyle intervention and inflammatory biomarker levels among African American women, respectively. We also seek to analyze the relationship between residing in a food desert/swamp and inflammatory biomarker levels, while gaining a qualitative perspective about community garden access among African American women. …

Surveying Tuberculosis Screening Practices Of South Carolina Hospital Employees, Tamara T. Carree

Theses and Dissertations

BACKGROUND: Every year tuberculosis (TB) causes over 10 millions of people globally and in recent years has caused over 9,000 cases annually in the United States. TB can be transmitted in hospital settings, and South Carolina hospitals, like hospitals elsewhere in the country maintain a responsibility to test their employees for this disease. Nosocomial infections of active TB among patients and healthcare workers can be burdensome on hospital resources. Testing healthcare workers and implementing prevention strategies are examples of administrative controls provided in the 2005 guidelines by the Centers for Disease Control and Prevention (CDC). Implementation of administrative controls are …

Circulating Calcium, Phosphorus, And Parathyroid Hormone And Aggressive Prostate Cancer In The North Carolina-Louisiana Prostate Cancer Project, Brittany Crawford

Theses and Dissertations

Prostate cancer is the most commonly diagnosed cancer among men in the United States. Despite improvements in screening, diagnostic methods, and treatment, African-American men have an increased risk of total and aggressive prostate cancer. In recent years, a growing body of evidence linking biomarkers of calcium and parathyroid hormone (PTH) to prostate cancer development has emerged. Circulating calcium, phosphorus, and PTH are homeostatically related. Prior studies linking prostate cancer and circulating calcium and PTH have produced inconclusive results, and no studies have examined the association between serum phosphorus and prostate cancer. The present study examined the relationship between circulating calcium, …

Factors Associated With Hospital Readmissions Among United States Dialysis Facilities, Amber B. Paulus

Theses and Dissertations

Hospital readmissions are a major burden for patients with end stage renal disease (ESRD). On average, one in three hospital discharges among patients with ESRD are followed by a readmission within 30 days. Currently, dialysis facilities are held accountable for readmissions via the ESRD Quality Incentive Program standardized readmission ratio (SRR) clinical measure. However, little is known about facility-level factors associated with readmission. Additionally, unlike other standardized measures of quality in the dialysis setting, incident patients within their first 90-days of dialysis are included in the performance calculation. This study analyzed CMS Dialysis Facility Report data from 2013 to 2016 …

The Influence Of Clinically Meaningful Factors On The Performance Of The Recommended Annual Diabetic Foot Screening, Trisha A. Sando

Theses and Dissertations

Background: Diabetic foot ulcers are the result of multiple complications from hyperglycemia and lead to poor quality of life and high healthcare costs. The annual diabetes foot screening exam (ADFSE) and prevention interventions can reduce DFUs up to 75%. In 2015, 71% of the US population received the ADFSE.

Objectives: The main objectives of this dissertation were: 1) to determine the association between adherence to diabetes self-management behaviors and the ADFSE, 2) to determine the association between concordant and discordant comorbidities and the ADFSE and 3) to determine the association between the performance of diabetes preventive care processes, number of …

Usefulness Of The Captia Syphilis Igg Eia Test Method And Reverse Algorithm For Detection Of Syphilis Infection In A Public Health Setting, Patricia Armour

Theses and Dissertations

Syphilis, a systemic sexually transmitted disease, is on the rise in the US, with infection rates the highest recorded since 1994 according to the CDC. Useful laboratory testing is an important diagnostic tool for determining individual syphilis infection and preventing community-wide disease spread.

The purpose of this study was to determine the usefulness of a specific automated treponemal test method, the Captia^TM Syphilis IgG EIA, and the syphilis reverse algorithm interpretation for detecting syphilis infection among patients seeking care in a public health clinic. The study employed a retrospective, nonexperimental descriptive correlational design with data collected between 2012-2013 from …