Epidemiology Commons^™

Protocol For Safe, Affordable, And Reproducible 1 Isolation And Quantitation 2 Of Sars-Cov-2 Rna From Wastewater, Monica Trujillo, Kristen Cheung, Anna Gao, Irene Hoxie, Sherin Kannoly, Nanami Kubota, Kaung Myat San, Davida S. Smyth, John J. Dennehy

Publications and Research

The following protocol describes our workflow for processing wastewater with the goal of detecting the genetic signal of SARS-CoV-2. The steps include pasteurization, virus concentration, RNA extraction, and quantification by RT-qPCR. We include auxiliary steps that provide new users with tools and strategies that will help troubleshoot key steps in the process. This protocol is one of the safest, cheapest, and most reproducible approaches for the detection of SARS-CoV-2 RNA in wastewater. Furthermore, the RNA obtained using this protocol, minus the pasteurization step, can be sequenced both using a targeted approach sequencing specific regions or the whole genome. The protocol …

Reproducibility And Sensitivity Of Thirty-Six Methods To Quantify The Sars-Cov-2 Genetic Signal In Raw Wastewater: Findings From An Interlaboratory Methods Evaluation In The U.S., Brian M. Pecson, Emily Darby, Charles N. Haas, Yamrot M. Amha, Mitchel Bartolo, Richard Danielson, Yeggie Dearborn, George Di Giovanni, Christobel Ferguson, Stephanie Fevig, Erica Gaddis, Donald Gray, George Lukasik, Bonnie Mull, Liana Olivas, Adam Olivieri, Yan Qu, Sars-Cov-2 Interlaboratory Consortium, John J. Dennehy

Publications and Research

In response to COVID-19, the international water community rapidly developed methods to quantify the SARS-CoV-2 genetic signal in untreated wastewater. Wastewater surveillance using such methods has the potential to complement clinical testing in assessing community health. This interlaboratory assessment evaluated the reproducibility and sensitivity of 36 standard operating procedures (SOPs), divided into eight method groups based on sample concentration approach and whether solids were removed. Two raw wastewater samples were collected in August 2020, amended with a matrix spike (betacoronavirus OC43), and distributed to 32 laboratories across the U.S. Replicate samples analyzed in accordance with the project's quality assurance plan …

Gender And Racial Disparity For Hospital Emergency Service Usage In Usa: A Quantitative Analysis For Various Age Groups During 2010–2017., Subhendra N. Sarkar, Anthony F. Devito, Evans Lespinasse, Faisal Khosa

Publications and Research

Background: Annually emergency department (ED) services are utilized by more than 100 million Americans making ED usage trends important determinants of healthcare quality, outcomes and cost. Previous workers have demonstrated the existence of disparity in various healthcare services in USA although a comprehensive analysis has not been undertaken. Dahlgren and Whitehead rainbow model has offered insights for multiple factors of influence on an individual’s health and focuses on the relationships among these factors. The Commission on Social Determinants of Health (CSDH; WHO initiatives) suggests that the social and environmental factors are at the root of most of the inequalities responsible …

Plasma Proteins That May Cause Parkinson’S Disease And Multiple Sclerosis: A Mendelian Randomization Study, Brigid A. Staley

Dissertations and Theses

Multiple sclerosis (MS) and Parkinson’s disease (PD) are progressively disabling neurologic disorders that profoundly affect quality of life and shorten life expectancy. There is no cure for either disease, and current treatments only alleviate symptoms and may cause serious side effects. The causes of MS and PD are not well understood. Previous epidemiologic studies have documented numerous environmental risk factors for both diseases. However, these studies are inherently prone to bias from confounding which may generate spurious results. The lack of unbiased evidence on environmental causes of MS and PD has been a critical barrier to fully understanding their pathophysiology. …

Coh-2000 - Community Health Interventions, Jose Nanin

Open Educational Resources

This syllabus includes OER materials and college policies for a fully online course that exposes students to a range of health promotion and disease prevention and management strategies used by health specialists to address community health challenges. Through readings and videos, as well as online course assignments and discussions, students learn about planning and designing interventions to improve the health of specific priority populations and communities-at-large.

Impact Of 2012 Spanish Health Care Reform On Hiv-Positive Immigrants: A Mixed Methods Approach, Megi Gogishvili

Dissertations and Theses

Background: The financial crisis of 2008 hit Spain hard. As a consequence, the government took multiple austerity measures, including reforms in the healthcare system in 2012. Specifically, the government reduced the budget for health and social services by 13.7% in 2012.The reduction was further followed with structural changes via the 2012 Royal Decree Law (RDL) and Royal Decree (RD).The 2012 RDL and RD entailed broad areas of action,but most importantly the Spanish National Health System (SNS) no longer covered undocumented immigrants. The 2012 RDL and RD excluded approximately 500,000 undocumented immigrants from SNS.

The number of immigrants in Spain has …

Proximity To Comprehensive Emergency Obstetric Care And The Utilization Of Facility-Based Delivery Services Across Six Low-And-Middle Income Countries, Chioma T. Amadi

Dissertations and Theses

Background: More than 90% of maternal deaths occur in low-and-middle-income countries (LMICs) and are largely attributed to preventable pregnancy-related causes. Comprehensive emergency obstetric care (EmOC), also known as signal functions, is the most effective life-saving intervention for managing obstetric and newborn emergencies. Health facilities offering delivery services are generally classified as having either comprehensive, basic or less than basic EmOC capacity based on their obstetric resources. Multiple EmOC methods are regularly utilized in characterizing facility obstetric capacity and this introduces inconsistencies that pose significant public health and policy implications for access to delivery care among women within a service environment. …

An Assessment Of Potential Causal Pathways Between Two Autoimmune Diseases: Mendelian Randomization Studies Of Rheumatoid Arthritis And Crohn’S Disease; And A Phenome-Wide Association Study To Assess Potential New Targets For Tocilizumab, An Interleukin-6 Inhibitor, Staci Abramsky Risman

Dissertations and Theses

Background

Rheumatoid arthritis (RA) and Crohn’s disease (CD) are two among a group of immune-mediated inflammatory diseases (IMIDs). These diseases are common, collectively affecting as many as two million Americans and as many as 28 million people worldwide. They have different clinical presentations but may have a common pathogenesis. An over-expression of tumor necrosis factor (TNF) and interleukin-6 (IL-6) have been proffered as a causal factor for IMIDs. These and other IMIDs may co-occur in patients, and it has been shown that patients with one IMID may have an increased risk of another IMID. What is not clear is whether …

Exploration Of The Complex Relationship Among Multilevel Predictors Of Prep Use Among Men Who Have Sex With Men In The United States, Kristina M. Rodriguez

Dissertations and Theses

Background: Men who have sex with men (MSM) remain the group most heavily affected by HIV in the United States (US), with MSM of color further disproportionately represented. In July 2012, the US Food and Drug Administration (FDA) approved the use of tenofovir disoproxil fumarate plus emtricitabine (TDF-FTC, Truvada) for use as pre-exposure prophylaxis (PrEP) in HIV-negative adults who are at high-risk of HIV infection. Despite its effectiveness, PrEP prescriptions are reaching only a small proportion of those who could benefit from the drug and prescription rates vary both by race and geographic region. The goal of this dissertation was …

Pandemics And Methodological Developments In Epidemiology History, Alfredo Morabia

Publications and Research

No abstract provided.

Leveraging Technology To Blend Large-Scale Epidemiologic Surveillance With Social And Behavioral Science Methods: Successes, Challenges, And Lessons Learned Implementing The Unite Longitudinal Cohort Study Of Hiv Risk Factors Among Sexual Minority Men In The United States, H. Jonathon Rendina, Ali J. Talan, Nicola F. Tavella, Jonathan Lopez Matos, Ruben H. Jimenez, S. Scott Jones, Brian Salfas, Drew Westmoreland

Publications and Research

The use of digital technologies to conduct large-scale research with limited interaction (i.e., no in-person contact) and objective endpoints (i.e., biological testing) has significant potential for the field of epidemiology, but limited research to date has been published on the successes and challenges of such approaches. We analyzed data from a cohort study of sexual minority men across the United States, collected using digital strategies during a 10-month period from 2017 to 2018. Overall, 113,874 individuals were screened, of whom 26,000 were invited to the study, 10,691 joined the study, and 7,957 completed all enrollment steps, including return of a …

Hypertension And Hiv In An Urban Slum Setting, Port-Au-Prince, Haiti, Olga Tymejczyk

Dissertations and Theses

Background: Rapidly growing urban slum settings increasingly face co-occurring communicable and non-communicable health crises, against the backdrop of extreme poverty, and social and environmental vulnerability. In Haiti, sparse data suggest a growing burden of hypertension and cardiovascular disease (CVD), along with substantial prevalence of HIV, increasingly recognized as a major CVD risk factor. As life-saving antiretroviral treatment (ART) is extended to more people living with HIV (PLWH), their risk of CVD increases with longer life expectancy and possibly cumulative ART exposure. Pregnant HIV-positive women may face additional cardiovascular vulnerability, due to the risk of gestational hypertension and pre-eclampsia. Integration of …

Trends In The Timeliness Of Hiv Diagnosis And Antiretroviral Treatment Initiation Before, During And After The “Treat All” Recommendation – New York City, 2006 - 2015, Mckaylee Robertson

Dissertations and Theses

BACKGROUND: Voluntary HIV testing followed by immediate antiretroviral treatment (ART) initiation (universal testing and treatment) has become an integral part of strategies to eliminate HIV and control the HIV/AIDS epidemic. Minimizing the time from HIV infection to ART initiation is essential for universal test and treatment to be optimally effective. In New York City, an epicenter of the HIV epidemic, the ‘treat all’ recommendation, immediate treatment for all people diagnosed with HIV, was made in late 2011, and efforts to ‘treat all’ were contemporaneous with large scale HIV testing initiatives in NYC. The overarching goal of this dissertation was to …

Extreme Obesity Among Adults In The United States: Spatial Variation And The Association With Mortality, Carrie Mills

Dissertations and Theses

Objectives: The purpose of this dissertation was to create small area estimates to describe and explore the county-level spatial variation of extreme obesity among adults in the United States and to assess the county-level association and spatial variation of extreme obesity and mortality.

Methods: The Behavioral Risk Factor Surveillance System was used in conjunction with data from the Census Bureau to estimate county-level model-predicted prevalence of extreme obesity using multilevel regression and poststratification. Spatial dependence of estimates was assessed using global Moran’s Index, and local Moran’s Indices were used to identify clusters of higher and lower rates of extreme obesity …

Comorbidities And Medication Adherence Among Older Individuals Living With Hiv In The United States, Amanda M. Kong

Dissertations and Theses

The number of people living with HIV (PLWH) ≥65 years old is increasing in the United States (US) as PLWH live longer. In 2015, there were nearly 1 million people living with diagnosed HIV in the US and under 10% were age ≥65. By 2035, the proportion of PLWH in this age group is projected to be 27%. Like the general population of elderly individuals, as they age, PLWH face age-related comorbidities, many of which require routine medical care and daily medications, in addition to daily antiretroviral therapy (ART) for treatment of HIV. Previous research has found that PLWH develop …

Using Marginal Structural Models To Control For Time-Dependent Confounding And Detect Effect Modification In A Randomized Control Trial With A Time-Varying Exposure, Non-Adherence And Missing Data, Elizabeth A. Lancet

Dissertations and Theses

Background: Unlike traditional regression used in the Intention to Treat (ITT) approach, Marginal Structural Models (MSM) can account for joint effects of baseline and subsequent treatments as well as the presence of time-dependent confounding influenced by prior treatment and selection bias due to censoring. In addition, MSMs have been theorized to be able to assist investigators in determining the overall benefit of a drug in the total population as they are able to provide a summary effect size across all strata of an effect modifier which cannot be done via tradition regression techniques. The overall goal of this dissertation is …

A Mendelian Randomization Study Of Coronary Artery Disease And Three Amino Acids: Alanine, Glycine, And Glutamine, Allan Uribe

Dissertations and Theses

Cardiovascular disease is the leading cause of death worldwide. Coronary Artery Disease (CAD) accounts for the majority of those deaths. Observational studies have identified risk factors that have been helpful in lowering the death rate, including hypertension, high cholesterol, diabetes, smoking, physical inactivity and poor diet. The effects of these risk factors on CAD remain unclear. To clarify the effect of three amino acids, alanine, glutamine, and glycine on CAD I applied a two sample Mendelian randomization analysis to extensively genotyped observational data. In a sample with up to 184,000 individuals and approximately 60,000 controls, SNPs that reached genome wide …

Determination Of Anxiolytic And Antidepressant Medicines In New York City Wastewater Samples, Jasmine J. Gayle

Student Theses

Wastewater-based epidemiology (WBE) provides information about a population’s exposure to certain chemical agents, such as drugs of abuse and medicines, by the analysis of human biomarkers, also known as excretion products, in wastewater samples. Although this is a growing field worldwide, mainly in Europe, Oceania, and Asia, limited data from the US are currently available. We developed and validated an analytical method to quantitatively and qualitatively determine the presence of commonly prescribed drugs to treat anxiety (alprazolam, buspirone, clonazepam, lorazepam, and propranolol) and depression (bupropion, citalopram, clomipramine, duloxetine, fluoxetine, imipramine, paroxetine, sertraline, and venlafaxine) in wastewater using liquid chromatography tandem …

Burden Of Lipohypertrophy Among Insulin Dependent Diabetes Mellitus Patients In China: An Analysis Of Outcomes And Impact Of Pen Needle Reimbursement Policy, Arthi Chandran

Dissertations and Theses

Background

Diabetes is a global epidemic and with an aging population accompanied by rapid urbanization China ranks highest in disease prevalence and associated burden. Independent of diabetes type, insulin is an eventual and costly requirement for disease management. The consequences of insulin administration however are poorly understood. Lipohypertrophy (LH) is one such consequence. It is hypothesized that method of insulin delivery and poor delivery technique are significant risk factors for this condition which is believed to alter insulin pharmacodynamics. Subsequently, insulin pen needles are a critical component of care however access to pen needles varies across China.

Objective

The objective …

Changing Neighborhoods And Residents’ Health Perceptions: The Heart Healthy Hoods Qualitative Study, Paloma Conde, Marta Gutiérrez, Maria Sandin, Julia Díez, Luisa N. Borrell, Jesús Rivera-Navarro, Manuel Franco

Publications and Research

Cities, and therefore neighborhoods, are under constant change. Neighborhood changes may affect residents’ health in multiple ways. The Heart Healthy Hoods (HHH) project studies the association between neighborhood and residents’ health. Focusing on a middle–low-socioeconomic neighborhood in Madrid (Spain), our aim was to describe qualitatively its residents’ perceptions on the urban changes and their impacts on health. We designed a qualitative study using 16 semi-structured interviews including adult residents and professionals living or working in the area. Firstly, we described the perceived main social and neighborhood changes. Secondly, we studied how these neighborhood changes connected to residents’ health perceptions. Perceived …

Obesity, Type 2 Diabetes, And Dietary Acculturation Among Foreign-Born Blacks In New York City, Margrethe F. Horlyck-Romanovsky

Dissertations and Theses

Background: Black immigration to the US quadrupled between 1980 and 2000, and between 2000 and 2013 it further increased by 56%. The US Census estimates that by 2060, 16.5% of the US Black population will be foreign-born. Half of all foreign-born Blacks (FBBs) in the US, or more than 1.9 million people, are from the Caribbean, and of those, 682,000 were born in Jamaica alone. Besides the Caribbean, there are 1.36 million immigrants from sub-Saharan Africa. In New York City, non-Hispanic black Caribbean and West African immigrants constitute 19% and 4%, respectively, of the total foreign-born population. Research is limited …

First Trimester Medication Abortion Practice In The United States And Canada, Heidi E. Jones, Katharine O'Connell White, Wendy V. Norman, Edith Guilbert, E. Steve Lichtenberg, Maureen Paul

Publications and Research

We conducted a cross-sectional survey of abortion facilities from professional networks in the United States (US, n = 703) and Canada (n = 94) to estimate the prevalence of medication abortion practices in these settings and to look at regional differences. Administrators responded to questions on gestational limits, while up to five clinicians per facility reported on 2012 medication abortion practice. At the time of fielding, mifepristone was not approved in Canada. 383 (54.5%) US and 78 (83.0%) Canadian facilities participated. In the US, 95.3% offered first trimester medication abortion compared to 25.6% in Canada. While 100% of providers were …

Public Health Research Priorities To Address Us Human Trafficking, Emily F. Rothman, Hanni Stoklosa, Susie B. Baldwin, Makini Chisolm-Straker, Rumi Kato Price, Holly G. Atkinson

Publications and Research

In this Perspective, HEAL Trafficking, the nation's leading public health anti-trafficking organization maps out a national research agenda to tackle the problem of human trafficking. Given the paucity of research on trafficking, HEAL Trafficking engaged its membership in a consensus development process throughout 2016 to develop its national research agenda. HEAL Trafficking proposes five priorities that public health researchers should focus on in the decade ahead to make meaningful progress on preventing and responding to human trafficking in the Unites States.

Incorporating Place And Space: A Hierarchical Spatial Approach To Exploring Preventable Congestive Heart Failure Hospitalizations In New York City, Rachael Weiss Riley

Dissertations and Theses

Background: Faced with rising medical care costs, increasing prevalence, and widening health disparities, preventing congestive heart failure (CHF) hospitalizations is a central public health concern. Despite evidence of geographical clustering in preventable CHF admissions, there is a lack of research designed to examine spatial patterning of CHF and the local area neighborhood determinants that contribute to this variability. This study sought to assess and evaluate the importance of both space and place in analyzing preventable CHF hospitalizations and readmissions by applying appropriate statistical techniques, clarifying the assumption inherent in each method, and interpreting the findings within the context of existing …

The Role Of Socioeconomic Context In The Association Between Educational Attainment And Morbidity And Mortality, Jennifer Brite

Dissertations and Theses

Although the association between educational attainment and health is one of the most studied in the social science, little is known about the role of social and economic context. Fundamental Cause Theory suggests that the education-health gradient will be weakest in contexts where the better educated are unable to leverage their resources to achieve better health. This dissertation tests several different factors that may moderate the association between educational attainment and morbidity and mortality: 1. Demographic characteristics, including race, immigration status, and gender, 2. Status consistency (defined as education equivalent to that required for current occupation), 3. Unemployment rates at …

Quantitative Analysis Of Opioids And Cannabinoids In Wastewater Samples, Alethea Jacox

Student Theses

Wastewater-based epidemiology is an innovative approach that uses the analysis of human excretion products in wastewater to obtain information about exposure to drugs in defined population groups. We developed and validated an analytical method for the detection and quantification of opioids (morphine, oxycodone, hydrocodone, oxymorphone and hydromorphone), and cannabinoids (9-tetrahydrocannabinol, 11-nor 9-carboxy- tetrahydrocannabinol (THCCOOH) and THCCOOH-glucuronide) in raw influent wastewater samples by ultra-high performance liquid chromatography-tandem mass spectrometry. Method validation included linearity (5–1 000 ng/L for opioids, 10–1 000 ng/L for cannabinoids), imprecision (<21.2%), accuracy (83%–131%), matrix effect (from –35.1% to –14.7%) and extraction efficiency (25%–84%), limit of detection (1–5 ng/L) and quantification (5–10 ng/L) and auto-sampler stability (no loss detected). River, sewage overflow and wastewater samples were collected in triplicate from different locations in New York City and stored at -20 C until analysis. River water samples were negative for all the compounds. Water from sewage overflow location tested positive for morphine (10.7 ng/L), oxycodone (4.2–23.5 ng/L), oxymorphone (4.8 ng/L) and hydromorphone (4.2 ng/L). Wastewater samples tested positive for morphine (133.0– 258.3 ng/L), oxycodone (31.1– 63.6 ng/L), oxymorphone (16.0–56.8 ng/L), hydromorphone (6.8–18.0 ng/L), hydrocodone (4.0– 12.8 ng/L) and THCCOOH (168.2– 772.0 ng/L). This method is sensitive and specific for opioids and marijuana determination in wastewater samples.

Research Methods In Occupational Health Psychology, Irvin Sam Schonfeld, Chu-Hsiang Chang

Publications and Research

http://www.springerpub.com/occupational-health-psychology.html

Occupational Health Psychology (OHP) is a rapidly expanding interdisciplinary field that focuses on the science and practice of psychology in promoting and developing workplace health- and safety-related initiatives. This comprehensive text for undergraduate and graduate survey courses is the first to encompass a wide range of key issues in OHP. It draws from the domains of psychology, public health, preventive medicine,nursing, industrial engineering, law, and epidemiology to focus on the theory and practice of protecting and promoting the health, well-being, and safety of individuals in the workplace and improving the quality of work life.

The text addresses key psychosocial …

The Effects Of Health-Related Fitness On School Attendance In New York City 6th-8th Grade Youth, Emily M. D'Agostino

Dissertations, Theses, and Capstone Projects

Background: Only 42% of youth ages 6-11 in the United States meet the World Health Organization’s recommendation for ≥60 minutes of daily moderate to vigorous physical activity. Estimates for adolescents ages 12-19 are even lower, ranging from 8-17%. Literature suggests low levels of youth health-related fitness (fitness) may negatively impact attendance, potentially due to reduced physical and psychosocial wellness. Nationally, 10-15% of (5-7.5 million) students are chronically absent, meaning that they miss ≥10% of the school year (or ≥20 days of school per year). Moreover, 20-30% of students in high-poverty, urban school districts do not attend school regularly (≥6 days …

Multilevel Analysis Of Individual, Neighborhood, And Health Care Facility Characteristics Associated With Achievement And Maintenance Of Hiv Viral Suppression Among Persons Newly Diagnosed With Hiv In New York City, Ellen W. Wiewel

Dissertations, Theses, and Capstone Projects

Objective

To investigate the effect of individual, health care facility, and neighborhood characteristics on achievement and maintenance of HIV viral suppression, among New York City residents aged 13 years and older diagnosed with HIV between 2006 and 2012.

Methods

I used individual-level data from the New York City HIV surveillance registry and Case Surveillance-Based Sampling, facility-level data from the surveillance registry, and neighborhood-level data from the U.S. Census and American Community Survey. The outcomes of interest were first viral suppression after diagnosis (Aims 1 and 3; ≤400 copies/mL) and virologic failure after first suppression among persons who achieved suppression (Aim …

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 …