Epidemiology Commons^™

Dna Methylation Signatures Of Chronic Low-Grade Inflammation Are Associated With Complex Diseases, Symen Ligthart, Carola Marzi, Stella Aslibekyan, Michael M. Mendelson, Karen N. Conneely, Toshiko Tanaka, Elena Colicino, Lindsay L. Waite, Roby Joehanes, Weihua Guan, Jennifer A. Brody, Cathy Elks, Riccardo Marioni, Min A. Jhun, Golareh Agha, Jan Bressler, Cavin K. Ward-Caviness, Brian H. Chen, Tianxiao Huan, Kelly Bakulski, Elias L. Salfati, Whi-Empc Investigators, Giovanni Fiorito, Charge Epigenetics Of Coronary Heart Disease, Simone Wahl, Katharina Schramm, Jin Sha, Dena G. Hernandez, Allan C. Just, Jennifer A. Smith, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background: Chronic low-grade inflammation reflects a subclinical immune response implicated in the pathogenesis of complex diseases. Identifying genetic loci where DNA methylation is associated with chronic low-grade inflammation may reveal novel pathways or therapeutic targets for inflammation.

Results: We performed a meta-analysis of epigenome-wide association studies (EWAS) of serum C-reactive protein (CRP), which is a sensitive marker of low-grade inflammation, in a large European population (n = 8863) and trans-ethnic replication in African Americans (n = 4111). We found differential methylation at 218 CpG sites to be associated with CRP (P < 1.15 × 10^–7) in the discovery panel …

Flavored Electronic Cigarette Use And Smoking Among Youth., Hongying Dai, Jianqiang Hao

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND OBJECTIVE: Flavored electronic cigarettes (e-cigarettes) are not prohibited in the United States, and e-cigarette flavors proliferate on the market. This study sought to examine flavored e-cigarette use and its association with smoking among youth.

METHODS: Estimates of flavored e-cigarette use from the 2014 National Youth Tobacco Survey were investigated. A logistic regression model was used to assess whether flavored e-cigarette use was associated with (1) intention to initiate cigarette use among never-smoking youth (n = 16 471), (2) intention to quit tobacco use among current-smoking youth (n = 1338), and (3) perception of tobacco's danger among all respondents …

Perceptions Of Peer Sexual Behavior: Do Adolescents Believe In A Sexual Double Standard?, Michael Young, Susan Cardenas, Joseph Donnelly, Mark J. Kittleson

Department of Public Health Scholarship and Creative Works

BACKGROUND

The purpose of the study was to (1) examine attitudes of adolescents toward peer models having sex or choosing abstinence, and (2) determine whether a “double standard” in perception existed concerning adolescent abstinence and sexual behavior.

METHODS

Adolescents (N = 173) completed questionnaires that included 1 of 6 randomly assigned vignettes that described male and female peer models 3 ways: (1) no information about model's sexual behavior, (2) model in love but choosing abstinence, and (3) model in love and having sex. Participants read the vignette to which they had been assigned and responded to statements about the peer …

Accuracy Of Name And Age Data Provided About Network Members In A Social Network Study Of People Who Use Drugs: Implications For Constructing Sociometric Networks, April M. Young, Abby E. Rudolph, Amanda E. Su, Lee King, Susan Jent, Jennifer R. Havens

Epidemiology and Environmental Health Faculty Publications

Purpose—Network analysis has become increasingly popular in epidemiologic research, but the accuracy of data key to constructing risk networks is largely unknown. Using network data from people who use drugs (PWUD), the study examined how accurately PWUD reported their network members’ (i.e., alters’) names and ages.

Methods—Data were collected from 2008 to 2010 from 503 PWUD residing in rural Appalachia. Network ties (n=897) involved recent (past 6 months) sex, drug co-usage, and/or social support. Participants provided alters’ names, ages, and relationship-level characteristics; these data were cross-referenced to that of other participants to identify participant-participant relationships and to determine …

Chemical Reactions: Marijuana, Opioids, And Our Families, Denise A. Hines Ph.D, Staci Gruber Ph.D, John F. Kelly Ph.D, Kathleen M. Palm Reed, Hilary Smith Connery M.D., Ph.D.

Mosakowski Institute for Public Enterprise

Chemical Reactions: Marijuana, Opioids, and Our Families is the seventh Massachusetts Family Impact Seminar. This seminar was designed to emphasize a family perspective in policymaking on issues related to the legalization of marijuana and managing the opioid abuse crisis in the Commonwealth. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families.

Immunomodulators As Therapeutic Agents In Mitigating The Progression Of Parkinson's Disease, Bethany Grimmig, Josh Morganti, Kevin Nash, Paula C. Bickford

Sanders-Brown Center on Aging Faculty Publications

Parkinson’s disease (PD) is a common neurodegenerative disorder that primarily afflicts the elderly. It is characterized by motor dysfunction due to extensive neuron loss in the substantia nigra pars compacta. There are multiple biological processes that are negatively impacted during the pathogenesis of PD, and are implicated in the cell death in this region. Neuroinflammation is evidently involved in PD pathology and mitigating the inflammatory cascade has been a therapeutic strategy. Age is the number one risk factor for PD and thus needs to be considered in the context of disease pathology. Here, we discuss the role of neuroinflammation within …

‘Because I Don’T Know’: Uncertainty And Ambiguity In Closed-Ended Reports Of Perceived Discrimination In Us Health Care, Chih-Yuan Lee, Amy Irby-Shasanmi

Department of Public Health Scholarship and Creative Works

Objective

Surveys often ask respondents to assess discrimination in health care. Yet, patients’ responses to one type of widely used measure of discrimination (single-item, personally mediated) tend to reveal prevalence rates lower than observational studies would suggest. This study examines the meaning behind respondents’ closed-ended self-reports on this specific type of measure, paying special attention to the frameworks and references used within the medical setting.

Design

Twenty-nine respondents participated in this study. They were asked the widely used question: ‘Within the past 12 months when seeking health care do you feel your experiences were worse than, the same as, or …

Palliative Chemotherapy Among People Living In Poverty With Metastasised Colon Cancer: Facilitation By Primary Care And Health Insurance, Kevin M. Gorey, Emma Bartfay, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty, Nancy L. Richter, Madhan K. Balagurusamy

Social Work Publications

Background: Many Americans with metastasised colon cancer do not receive indicated palliative chemotherapy. We examined the effects of health insurance and physician supplies on such chemotherapy in California.

Methods: We analysed registry data for 1199 people with metastasised colon cancer diagnosed between 1996 and 2000 and followed for 1 year. We obtained data on health insurance, census tract-based socioeconomic status and county-level physician supplies. Poor neighbourhoods were oversampled and the criterion was receipt of chemotherapy. Effects were described with rate ratios (RR) and tested with logistic regression models.

Results: Palliative chemotherapy was received by less than half of the participants …

Self-Care And Mobility Disability At Mid-Life In Lucky Few, Early-, And Late-Baby Boom Birth-Cohorts, Carlos Siordia

Journal of Health Disparities Research and Practice

Disability is related in definite ways with makers of social stratum, as it can be influenced by and has the potential to contribute to the production and reproduction of social stratification. Intersectional markers of social stratification processes are ignored determinants of health. The Class, Race, Sex (CRS) hypothesis presented here argues that a low-education, racial-minority, and female disadvantage will compound to affect the prevalence and risks of disability. The evidence presented validates the CRS hypothesis by showing that disability prevalence and risk clusters first by class, race, and then sex. The cross-sectional study of community-dwelling adults in the Unites States, …

Inequitable Chronic Lead Exposure: A Dual Legacy Of Social And Environmental Injustice, Tamara Leech, Elizabeth A. Adams, Tess D. Weathers, Lisa K. Staten, Gabriel M. Filippelli

Department of Public Health Scholarship and Creative Works

Both historic and contemporary factors contribute to the current unequal distribution of lead in urban environments and the disproportionate impact lead exposure has on the health and well-being of low-income minority communities. We consider the enduring impact of lead through the lens of environmental justice, taking into account well-documented geographic concentrations of lead, legacy sources that produce chronic exposures, and intergenerational transfers of risk. We discuss the most promising type of public health action to address inequitable lead exposure and uptake: primordial prevention efforts that address the most fundamental causes of diseases by intervening in structural and systemic inequalities.

A Public Health-Based Approach To German Gaming Regulation, Knut Walter, Gerhard Buehringer

International Conference on Gambling & Risk Taking

The current situation of the German gambling market can be characterized by an unrelated framework of different legal systems, different regulatory authorities and different control principles, and has led to (1) an increasing number of court decisions and information requests by European Commission questioning parts of that regulatory system, (2) public tolerance of illicit gambling, and consequently (3) a lack of consumer protection.

Taking RENO Model 1.0 and 2.0 seriously, a new and comprehensive regulatory framework based on common consumer protection standards for all types of gambling – land-based and online, state-owned and private operated – has been developed and …

Monitoring Gambling Impacts In Massachusetts: Honing Strategies And Preventing Harm, Rachel A. Volberg, Amanda Houpt

International Conference on Gambling & Risk Taking

In November 2011, an Act Establishing Expanded Gaming in the Commonwealth of Massachusetts was signed into law (Chapter 194 of the Acts of 2011). This legislation permits casinos and slot parlors in Massachusetts under the regulatory auspices of the Massachusetts Gaming Commission (MGC). Section 71 of the Expanded Gaming Act requires the MGC to establish an annual research agenda to assist in understanding the effects of casino gambling in Massachusetts and in minimizing the negative impacts. Research activities launched thus far include a comprehensive study of the social and economic impacts of casino gambling in Massachusetts (SEIGMA), a cohort study …

Antenatal Stressful Life Events And Postpartum Depression In The United States: The Role Of Women’S Socioeconomic Status At The State Level, Soumyadeep Mukherjee

FIU Electronic Theses and Dissertations

The purpose of this dissertation was to examine patterns of antenatal stressful life events (SLEs) experienced by women in the United States (U.S.) and their association with postpartum depression (PPD). It further explored the role of women's state-level socio-economic status (SES) on PPD; the racial/ethnic dispartites in SLE-PPD relationship; and the role of provider communication on perinatal depression.

Data from 2009–11 Pregnancy Risk Assessment Monitoring System (PRAMS) and SES indicators published by the Institute of Women’s Policy Research (IWPR) were used. Latent class analysis (LCA) was performed to identify unobserved class membership based on antenatal SLEs. Multilevel generalized linear mixed …

Demographic Profile, Geographic Distribution, Disability Prevalence, And Likelihood Of Being In-Poverty Amongst Grandparents Responsible For Grandchildren, Carlos Siordia, Mary E. Rauktis

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

Evidence-based research on Grandparents Responsible for Grandchildren (GRfG) continues to grow in recent decades. This brief report expands global knowledge on custodial grandparents by making use of a large data resource in the United States (US). The specific aim was to delineate the demographic profile, geographic distribution, and prevalence of specific-disabilities for the GRFG population in the US mainland. We also explore how demographic factors are associated with likelihood of being in-poverty. The analysis used data from the 2009-2013 American Community Survey (ACS) 5-year Public Use Microdata Sample (PUMS) file. The ACS is a nationally representative, yearly, statistical survey administered …

Disparities Among Minority Women With Breast Cancer Living In Impoverished Areas Of California, Sundus Haji-Jama, Kevin M. Gorey, Isaac N. Luginaah, Guangyong Zou, Caroline Hamm, Eric J. Holowaty

Social Work Publications

Background: Interaction effects of poverty and health care insurance coverage on overall survival rates of breast cancer among women of color and non-Hispanic white women were explored. Methods: We analyzed California registry data for 2,024 women of color (black, Hispanic, Asian, Pacific Islander, American Indian, or other ethnicity) and 4,276 non-Hispanic white women (Anglo-European ancestries and no Hispanic-Latin ethnic backgrounds) diagnosed with breast cancer between the years 1996 and 2000 who were then followed until 2011. The 2000 US census categorized rates of neighborhood poverty. Health care insurance coverage was either private, Medicare, Medicaid, or none. Cox regression was used …

Maternal, Environmental, And Social Context Predicts Diarrheal Infection Incidence In Young Children In Sundarbans, India, Sohini Mukherjee, Laura M. Glynn

Student Scholar Symposium Abstracts and Posters

Diarrheal infection is the third leading cause of childhood mortality in India and is responsible for 13% of all deaths per year in children under 5 years of age (Lakshaminarayan & Jayalakshmy, 2015). The Sundarbans in West Bengal is amongst the poorest regions of India and is the epitome of abject deprivation and the acute struggle against geographical and socioeconomic challenges. The incidence of diarrhea in this region is considerably high; about 42,000 reported cases occur per month, and one in five diarrhea cases are reported as severe (with blood in stool). In addition, 37% of children hospitalized for ailments …

A Yellow Fever Epidemic: A New Global Health Emergency?, Lawrence O. Gostin, Daniel Lucey

Georgetown Law Faculty Publications and Other Works

The worst yellow fever epidemic in Angola since 1986 is rapidly spreading, including the capital, Luanda. In Angola, the epidemic began in December 2015 and the laboratory-confirmed outbreak was reported to the World Health Organization (WHO) on January 21, 2016. Angola has had 2023 suspected cases and 258 deaths as of April 26, 2016. China, the Democratic Republic of Congo, and Kenya also have reported cases arising from infected travelers from Angola. Namibia and Zambia also share a long border with Angola, with considerable population movement between the countries. Similar to other recent epidemics, quick and effective action to stop …

An Integrated Strategy For Strengthening Worcester's Regional Food System: Key Roles For Education And Information, Joel Simonson

International Development, Community and Environment (IDCE)

Food security and access to healthy food are public health issues that continue to persist in the United States and are ones that are strongly influenced by social and environmental factors. In Worcester, Massachusetts there are many organizations that contribute to alleviating the resulting effects, but do not always have the capacity to reach full potential and expand upon current initiatives. Students can provide existing human resources and knowledge that would benefit all parties. This would allow for organizational capacity development, ultimately impacting local residents, and for students to gain deeper connections to the greater Worcester community while learning vital …

Facilitating Effective Communication Between First Responders And Older Adults During Fall Incidents: An Educational Intervention, Krystin M. Beeman, Erica L. Berger, Isabel A. Cabezas, Nicole M. Mathews

Dissertations, Masters Theses, Capstones, and Culminating Projects

PURPOSE. The purpose of this project was to provide first responders with communication strategies for older adults that may help when responding to fall- related calls. General information was also provided to First Responders on working with older adults with a focus on the aging process, fall risk factors, and communications strategies.

METHODS. A series of educational sessions to first responders at a local fire district were developed and presented by occupational therapy students. Materials were developed by presenters from evidence-based resources and tailored to the target population. Each presentation focused on statistics about older adults, the aging process, fall …

Suicidal Ideation In Patients Hospitalized For Emergency Medical Treatment Related To Physical Trauma: Effects Of Posttraumatic Stress And Depression, Erin E. Carney

Masters Theses & Specialist Projects

Survivors of physical trauma may be at increased risk for developing suicidal ideation and behavior both during and after their inpatient hospitalization for medical treatment of wounds. It remains to be understood why a population hospitalized for nonpsychiatric reasons may ultimately develop a desire to take their own life. The current study sought to answer this question by hypothesizing that symptoms of posttraumatic stress (PTS) and depression during the recovery period individually mediated the relationship between physical pain and suicidal ideation. Researchers assessed these relationships in 246 patients who were receiving emergency medical treatment for wounds associated with a physically …

Investigating Pakistan’S Contraception Rate Plateau: A Multilevel Analysis To Understand The Association Between Community Contextual Factors And Modern Contraception Use, Mahmooda Khaliq Pasha

USF Tampa Graduate Theses and Dissertations

South Asia has the highest absolute number of women with an unmet need for contraception in the world. The total number of women with unmet need is 142 million. Of this, Asia accounts for 84 million followed by Sub-Saharan Africa at 32 million. Within South Asia, some countries have seen unmet need decrease and the contraception rate increase; however, Pakistan remains the exception to the rule. Pakistan has a low rate of contraception use, high rate of contraception discontinuation, high unmet need and high rate of unwanted fertility.

A number of theories have hypothesized that community-level factors influence a couple’s …

Alzheimer's Biomarkers Are Correlated With Brain Connectivity In Older Adults Differentially During Resting And Task States, Yang Jiang, Haiqing Huang, Erin Abner, Lucas S. Broster, Gregory A. Jicha, Frederick A. Schmitt, Richard Kryscio, Anders H. Andersen, David Powell, Linda J. Van Eldik, Brian T. Gold, Peter T. Nelson, Charles D. Smith, Mingzhou Ding

Behavioral Science Faculty Publications

β-amyloid (Aβ) plaques and tau-related neurodegeneration are pathologic hallmarks of Alzheimer’s disease (AD). The utility of AD biomarkers, including those measured in cerebrospinal fluid (CSF), in predicting future AD risk and cognitive decline is still being refined. Here, we explored potential relationships between functional connectivity (FC) patterns within the default-mode network (DMN), age, CSF biomarkers (Aβ₄₂ and pTau₁₈₁), and cognitive status in older adults. Multiple measures of FC were explored, including a novel time series-based measure [total interdependence (TI)]. In our sample of 27 cognitively normal older adults, no significant associations were found between levels of Aβ …

The Impact Of Foster Care On Depression: An Examination Of Placement Type And Mental Health Service Utilization Among Children And Adolescents, Kisha Cummings

Dissertations, Theses, and Capstone Projects

Background: Children and adolescents in foster care with a history of complex trauma such as neglect, emotional, physical, and sexual abuse have a greater odds of being clinically diagnosed with depression in adulthood compared to children and adolescents without such a history. The current study examines the prevalence of depression in a national sample of children and adolescents aged 7 to 17 years. This study asks whether a) foster care is associated with a greater prevalence of depression among children and adolescents in foster care compared to children and adolescents not in foster care; b) there is an association between …

Gender Differences On The Interacting Effects Of Marital Status And Health Insurance On Long-Term Colon Cancer Survival In California, 1995-2014, Derek Campbell, Kevin M. Gorey, Isaac N. Luginaah, Guangyong Zou, Caroline Hamm, Eric J. Holowaty

Social Work Publications

Objectives. Long-term colon cancer survival is not well explained by main effects. We explored the interaction of age, gender, marital status, health insurance and poverty on 10-year colon cancer survival.

Methods. California registry data were analyzed for 5,776 people diagnosed from 1995 to 2000; followed until 2014. Census data classified neighborhood poverty. We tested interactions with regressions and described them with standardized rates and rate ratios (RR).

Results. The 5-way interaction was significant, suggesting larger 4-way disadvantages among non-Medicare-eligible people. A significant 4-way interaction was a 3-way interaction in non-high poverty neighborhoods only. Private insurance was protective for unmarried …

Socioecological Factors Influencing Women's Hiv Risk In The United States: Qualitative Findings From The Women's Hiv Seroincidence Study (Hptn 064)., Paula M Frew, Kimberly Parker, Linda Vo, Danielle Haley, Ann O'Leary, Dazon Dixon Diallo, Carol E Golin, Irene Kuo, Lydia Soto-Torres, Jing Wang, Adaora A Adimora, Laura A Randall, Carlos Del Rio, Sally Hodder, Hiv Prevention Trials Network 064 (Htpn) Study Team.

Epidemiology Faculty Publications

BACKGROUND: We sought to understand the multilevel syndemic factors that are concurrently contributing to the HIV epidemic among women living in the US. We specifically examined community, network, dyadic, and individual factors to explain HIV vulnerability within a socioecological framework.

METHODS: We gathered qualitative data (120 interviews and 31 focus groups) from a subset of women ages 18-44 years (N = 2,099) enrolled in the HPTN 064 HIV seroincidence estimation study across 10 US communities. We analyzed data from 4 diverse locations: Atlanta, New York City (the Bronx), Raleigh, and Washington, DC. Data were thematically coded using grounded theory methodology. …

Environmental Factors Associated With Body Mass Index Among Long Haul Truck Drivers, Charlotte Hughes Huntley

Walden Dissertations and Doctoral Studies

In 2009–2010, the prevalence of obesity among U.S. adults was 40%, and the prevalence was 69% among long haul truck drivers. Researchers have not established a clear relationship between working environment and weight among truck drivers. This quantitative cross-sectional study, using an ecological framework, evaluated the relationship between the working environment (sleep performance, food choices, driving environment, and activity level) and weight severity (e.g., body mass index [BMI]) among long haul truck drivers. One hundred and twenty six adults (46 + 10, years of age), including both genders (male = 97 and females = 29) completed an online questionnaire evaluating …

Hiv-Positive Status Disclosure Barriers In Stable Heterosexual Partners In Warri, Nigeria., Edith Nkechinyere Ogbozor

Walden Dissertations and Doctoral Studies

Nondisclosure of positive status drives the secondary transmission of human immunodeficiency virus (HIV) infection. This cross sectional quantitative survey study grounded by the consequence theory evaluates fear of stigma, lack of social support, and level of HIV-related knowledge as barriers to self-disclosure of HIV-positive status to stable heterosexual partners. A sample of 303 HIV-infected respondents (111 men and 192 women) accessing antiretroviral therapy at 4 designated centers in Warri, Nigeria, completed the self-administered questionnaires. Logistic regression analysis was used to assess the association between these factors and spousal HIV-positive status disclosure. Results demonstrated: (a) social support availability significantly predicted HIV …

Socioeconomic Status Mobility And Lifetime Exposure To Discrimination On Cardiovascular Disease Events, Nkenge H. Jones-Jack

Walden Dissertations and Doctoral Studies

Blacks in the United States have the highest rates of hypertension in the world, and their cardiovascular disease mortality rates are higher than for any other population group as a result of traditional risk factors such as obesity and stronger family history. However, additional underlying factors, such as social determinants of health (e.g., socioeconomic status [SES]) and macrosocial factors (e.g., racism), also correlate with adverse health outcomes. This study investigated whether the interaction between SES mobility over the lifecourse and lifetime racial discrimination influenced the extent to which hypertension contributed to the cardiovascular disease health disparities observed among Blacks in …

Poverty, Food Insecurity, And Obesity Among Urban And Rural Populations, Tameka Ivory Walls

Walden Dissertations and Doctoral Studies

Over 17 million food-insecure households are associated with increasing obesity rates across the United States. Although food insecurity and obesity are distinct social concerns, the two are linked and may be influenced by poverty and geographic location. Public health authorities and state leaders responsible for the health and nutrition of rural populations in particular would benefit from this information. The purpose of this quantitative cross-sectional study was to examine whether poverty mediated the relationship between food insecurity and obesity among urban and rural adults. The study was guided by the poverty, food insecurity, and obesity conceptual framework. The study addressed …

Space-Time Modelling Of Emerging Infectious Diseases: Assessing Leptospirosis Risk In Sri Lanka, Cameron C F Plouffe

Theses and Dissertations (Comprehensive)

In this research, models were developed to analyze leptospirosis incidence in Sri Lanka and its relation to rainfall. Before any leptospirosis risk models were developed, rainfall data were evaluated from an agro-ecological monitoring network for producing maps of total monthly rainfall in Sri Lanka. Four spatial interpolation techniques were compared: inverse distance weighting, thin-plate splines, ordinary kriging, and Bayesian kriging. Error metrics were used to validate interpolations against independent data. Satellite data were used to assess the spatial pattern of rainfall. Results indicated that Bayesian kriging and splines performed best in low and high rainfall, respectively. Rainfall maps generated from …