Epidemiology Commons^™

Access To Appropriate Care, Mortality, And Cost Of Inpatient Hospitalization In Infants With Omphalocele And Gastroschisis In The United States, Treeva A. Jaff

Electronic Theses & Dissertations (2024 - present)

Congenital abdominal wall defects (AWDs), including omphalocele (OM) and gastroschisis (GS), are rare but clinically significant conditions that require immediate surgical intervention and prolonged neonatal intensive care. OM is a midline defect in which abdominal organs protrude into the umbilical cord covered by a membranous sac, while GS is a full-thickness defect typically located to the right of the umbilicus through which organs protrude without protective coverage. OM is frequently associated with major co-occurring congenital anomalies and chromosomal abnormalities, while GS more commonly occurs as an isolated defect but requires more intensive surgical management. As survival rates have improved, research …

Understanding The Syphilis Resurgence Among Females Of Childbearing Age: Informing Prevention Efforts In New York State, Salvatore Currenti

Electronic Theses & Dissertations (2024 - present)

Syphilis is caused by Treponema pallidum and transmitted through direct contact with infected mucosal lesions and via vertical transmission during pregnancy (i.e., congenital). Transmission of syphilis to an infant during pregnancy (i.e., congenital syphilis [CS]) can lead to early fetal death, stillbirth, neonatal death, preterm birth, low birthweight, and congenital infection in infants. The United States (U.S.) is experiencing epidemic increases in both females of reproductive age with syphilis and infants with CS. In New York State (NYS), these trends have also occurred, especially after COVID-19 emergence, and increases in reported cases and incidence rates are comparable to national statistics. …

Hepatitis C Among Persons Who Inject Drugs In New York State: Progress Towards Elimination, Meredith A. Barranco

Electronic Theses & Dissertations (2024 - present)

Background: Hepatitis C virus (HCV) infection is one of the leading causes of liver disease in the United States (US) and worldwide. In the United States today, HCV is transmitted primarily through injection drug use (IDU) and therefore disproportionately impacts persons who inject drugs (PWID), a population with a range of complex social and health needs. HCV is not vaccine-preventable but can be cured in over 90% of cases with an 8–12-week course of daily direct-acting antiviral (DAA) medication. Since approval of curative medications in 2014, various jurisdictions have developed plans to eliminate HCV. In 2021, the New York State …

Associations Between Neighborhood Physical And Social Stressors During Sensitive Developmental Periods And Substance Use In Early Adulthood, Abigail M. Ulofoshio

Electronic Theses & Dissertations (2024 - present)

Background

Substance use is a major public health problem. Neighborhood disadvantage and related stressors have been linked to increased substance use in adolescence and early adulthood, although findings are mixed. No studies have explored whether the timing or accumulation of neighborhood stressors in childhood and adolescence impact substance use in early adulthood. This study aims to investigate to what extent physical and social neighborhood stress during sensitive developmental periods influence substance use dependency and illicit substance use in early adulthood.

Methods

We analyzed an imputed sample (n = 7,494) from the Avon Longitudinal Study of Parents and Children (ALSPAC), a …

Understanding Hepatitis C Risk And Harm Reduction Needs Among People Who Smoke Drugs: A Client-Centered Qualitative Inquiry, Maxwell Gustin

Anthropology

The spread of Hepatitis C virus (HCV) via non-injectable equipment is plausible, making people who smoke drugs (PWSD) at-risk for possible infection and transmission. While much research has been conducted into injection drug use (IDU), likely due to the rising opioid epidemic, limited studies focus on the risks PWSD face. Currently, state-funded syringe service programs (SSPs) provide harm reduction education and materials to combat these risks. Safer smoking initiatives have been created and are widely used by PWSD, and have access to SSPs. To gain better insight into the HCV and non-HCV-related risks and burdens PWSD face, a qualitative study …

Molecular Epidemiologic Studies Of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (Me/Cfs), Anil Kumar

Electronic Theses & Dissertations (2024 - present)

Background: Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) is a disabling multisystem complex disorder with no known etiology or approved treatment. Our studies aimed to assess the link between ME/CFS and autoimmune disease (AID) and cancer, and to identify potential biomarkers and biological mechanisms to further explore pathophysiology of this diseases.

Methods: All analyses were done using data from a case-control study of ME/CFS conducted by Dr. Roxana Moslehi and her collaborators. In our first study we estimated the cumulative incidences of AID and cancer among first degree relatives of 60 cases and 61 controls and compared cumulative …

Differences In Mental Health Outcomes In Immigrant Vs. U.S.-Born Populations In Urban Vs. Rural Areas In The United States, Zoë Gentles

Electronic Theses & Dissertations (2024 - present)

Background

The immigration process to the United States creates distinct mental stressors. These stressors are influenced by socioeconomic factors including income, education level and insurance status. In rural America, these factors are intensified due to a poor healthcare infrastructure that is limited. This study examines the relationship between urban-rural residence and mental health outcomes among immigrants vs. native-born residents in the United States.

Methods

Data from the National Health Interview Survey (NHIS) from 2019 and 2022 were used to examine the relationship. The exposure of interest was place of birth, and the outcome of interest was the presence of clinically …

Non-Profit Hospital Spending On Community Health Improvement: Catalysts, Impediments, And Opportunities In New York State, Isaac H. Michaels

Electronic Theses & Dissertations (2024 - present)

This dissertation assesses the distribution and determinants of spending by non-profit hospitals in New York State on community health improvement services and community benefit operations. Utilizing the Social Ecological Model of Health, this study considers multiple levels of influence on this spending, including organizational and community characteristics. Using quantitative analysis, it examines cross-sectional, spatial, and longitudinal patterns in spending and identifies organizational and community-level factors influencing it. Qualitative analysis investigates operational factors affecting spending, including individual and interpersonal influences. The results of this mixed-methods study can inform hospital administrators, public health officials, policymakers, and communities in optimizing policies and decision-making …

Association Of Non-Communicable Diseases With Severe Covid-19 Among People Living With And Without Diagnosed Hiv/Aids In New York State, Ravi Kumar Balu

Electronic Theses & Dissertations (2024 - present)

Background: People living with diagnosed HIV (PLWDH) have a higher chance of co-infections and co-morbidities than the general population. When SARS-CoV-2 was first reported in China in December 2019 and later declared a pandemic, it was speculated that PLWDH might be more prone to SARS-CoV-2 infection and severe disease outcomes given their increased vulnerability to other respiratory infections like influenza, pneumococcal pneumonia and tuberculosis. However, several facets of COVID-19 disease in PLWDH are incompletely understood, including whether non-communicable diseases (NCDs) are strong risk factors for severe disease outcomes and death as they are in the general population.

Methods: The data …

Polygenic Risk Scores Of Grip Strength In Men And Women With Or At Risk For Hiv, Sreevidya Sadananda Sadasiva Rao

Electronic Theses & Dissertations (2024 - present)

Background: Adequate hand function among older adults is necessary for the successful completion of activities of daily living and can affect whether an older adult is able to live independently. Current research highlights grip strength, the strength people have in their hands, as a robust predictor of morbidity and mortality, and explores the decline in grip strength over time. A person’s family history and genes (DNA) affect how much grip strength they have. Previous studies have identified genes that affect grip strength, mainly in European ancestry populations. In this study, we examined whether these genetic elements predict grip strength in …

Differences In Mental Health Care Use Between Urban And Rural Populations In New York State, 2017-2022, Anna J. Papa

Electronic Theses & Dissertations (2024 - present)

Objective

This study aimed to determine whether rural New York State residents receive mental health care at the same rate as urban residents, how poverty rates in New York State relate to rurality and mental health care use, and how pre-pandemic mental health care use rates compare to 2022 use rates. The goal was not to estimate the burden of disease, nor to estimate the number of patients engaged in care in each zip code, but to highlight the potential differences in service use between urban and rural New York State Office of Mental Health clients.

Methods

A secondary analysis …

Species Distribution And Logistic Regression Analysis Of Nosocomial Legionella Detection And Infection In New York State, 2017 – 2023, Roxann Brna

Legacy Theses & Dissertations (2009 - 2024)

Healthcare facilities are high-risk areas for legionellosis infections, as they have large, complex potable water systems ideal for Legionella proliferation, and they host susceptible populations. New York State regulation 10 NYCRR § 4-2: Protection Against Legionella in Healthcare Facilities was implemented in July 2016 to reduce healthcare-acquired legionellosis. This regulation mandated environmental surveillance of healthcare facilities’ potable water systems via culture. Data from these environmental reports were paired with data for cases of healthcare-acquired legionellosis infections for the years 2017-2023. Using these data, geographic Legionella species and serogroup distributions were described, and logistic regressions evaluated facility attributes associated with potable …

Extreme Temperature And Other Environmental Factors On Diabetes Admissions, Donghong Gao

Legacy Theses & Dissertations (2009 - 2024)

Background: Although total environmental factors have been linked with adverse health outcomes, the impacts of temperature and other total environmental factors on diabetes-related hospitalizations and emergency department (ED) visits remain inconclusive.Objective: This dissertation aims to Aim 1) test the associations between extreme heat and diabetes hospitalizations in the summer and its transitional months, identify populations vulnerable to extreme heat’s effects, and examine the modification effects of greenness on the heat-diabetes associations in warm months (Chapters 3 and 4); Aim 2) investigate the associations between extreme cold and diabetes hospitalizations in the winter and its transitional months, identify populations vulnerable to …

A Descriptive Analysis Of Depressive Symptoms And Body Image By Race/Ethnicity And Nativity Status Among Adolescents, Radhika Prasad

Electronic Theses & Dissertations (2024 - present)

Previous research on the immigrant health paradox among children and adolescents show a mental health advantage yet it is unclear if this applies in a similar magnitude to females (Fillion et al., 2018; Zarei et al., 2023). Immigrants may be exposed to stressors related to immigration and acculturation. Some research suggests that females respond more to stress through internalizing symptoms relative to males (Hall-Lande et al., 2007; Adkins et al., 2009). Given these gender differences in stress response, female immigrants may be particularly vulnerable to the psychological consequences of immigration related stressors. The immigrant health paradox has also overlooked subjective …

Associations Between Maternal Alcohol Consumption During Pregnancy And Selected Musculoskeletal Birth Defects Among Offspring In The National Birth Defects Prevention Study, Sarah Fisher

Legacy Theses & Dissertations (2009 - 2024)

Maternal alcohol consumption during pregnancy is known to be associated with poor pregnancy outcomes, including fetal alcohol spectrum disorders. However, evidence for associations between alcohol consumption during pregnancy and some major structural birth defects among offspring is conflicting or inconclusive. This dissertation used data from the National Birth Defects Prevention Study (NBDPS), a multi-site, population-based case-control study, to examine associations between maternal alcohol consumption and risk of three major musculoskeletal birth defects: gastroschisis, omphalocele, and craniosynostosis. Our analyses built upon previous analyses of these associations using NBDPS data, including larger sample sizes and more robust analytic methods to explore issues …

Prescription Opioid Misuse Among High School Students In The United States, By Sex And Race/Ethnicity, In 2019 And 2021, Deepika Reddy Kandhi

Legacy Theses & Dissertations (2009 - 2024)

Background: Drug overdose deaths in the U.S. have been increasing and are primarily related to opioid use. In 2019, an estimated 7.2% of US high school students reported misusing prescription opioids in the past 30 days. Prescription opioid misuse in adolescents may lead to development of a substance use disorder, overdose, or other serious harms. Some researchers have observed sex and race differences in prescription opioid use. This study aimed to identify patterns of prescription opioid misuse among adolescent subgroups categorized by both sex and race/ethnicity, to provide insight into intervention development and targeting.Methods: We analyzed data from the Youth …

Sleep Aid Use During Early Pregnancy And The Risk Of Birth Defects, Meredith M. Howley

Legacy Theses & Dissertations (2009 - 2024)

This dissertation examines the validity of maternal self-reported medication exposures and then explores the associations between self-reported sleep aid use, including zolpidem specifically, and birth defects using data from three population-based case-control studies conducted within the United States. The first aim of this dissertation was to explore agreement between two sources of prescription medication use in early pregnancy: medical records and self-reported interview data from the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS). We observed that agreement of prescription data between self-report and medical records varies by whether the medication is used chronically or episodically. While self-reported medication information …

Maternal Exposure Of Perfluoroalkyl Substances (Pfas) During Pregnancy And Wheeze In Children : The Upstate Kids Study, Faria Sharmin

Legacy Theses & Dissertations (2009 - 2024)

Background: Prenatal exposure to perfluoroalkyl substances (PFASs), a group of persistent environmental chemicals with endocrine disrupting abilities, has been associated with immunomodulation and may contribute to the etiology of asthma in young children. The need for research and additional prospective analysis clearly exists to measure the impact of the chemicals (PFAS) on child wheeze or asthma. We used newborn dried blood spots to quantify two PFAS and their associations with infant wheeze in the Upstate KIDS population.Methods: We measured, perfluoro octane - sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) in 2071 singleton and 1040 twin infants born to mothers in …

Association Of Prenatal Exposure To Air Pollutants With Select Birth Defects Using The Case-Cohort Approach, Abigail Jeanne Stamm

Legacy Theses & Dissertations (2009 - 2024)

Background: Annually, 3-5% of infants are born with birth defects in the United States. In New York State (NYS), air pollution, specifically ozone (O3) and fine particulate matter (PM2.5), is detectable at levels that affect human health. Air pollution is associated with poor birth outcomes and contains components that are suspected to cause oxidative stress, which is one mechanism by which birth defects are formed.Methods: This study investigated the relationship between the development of select birth defects (oral clefts, craniosynostosis, and clubfoot) in singleton live births in NYS between 2002 and 2015 and weekly peak and average concentrations of O3 …

Trajectories Of Maternal Parenting Stress And Adolescent Behavioral Symptoms In Unmarried Families : The Roles Of Family Immigration Status, Harsh Parenting, And Father’S Early Involvement, Fei Tang

Legacy Theses & Dissertations (2009 - 2024)

BackgroundAdolescence is a critical period for developing social and emotional wellbeing. Adolescents experience many physical and social changes, making them vulnerable to adaptive and behavioral problems. Compared to their peers in married families, adolescents in unmarried families may be at particularly elevated risk of developing internalizing and externalizing behavioral problems, identifying key risk factors in a family context could provide insights on the development of family-based interventions. Mothers are often seen as the center of the environmental context of children development, their responsiveness to children may be impacted by their economic and psychological resources, which could crucially affect the wellbeing …

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Step Towards Unfolding The Mystery, Aditi Kamlesh Bhanushali

Legacy Theses & Dissertations (2009 - 2024)

AbstractBackground: Myalgic Encephalomyelitis, also known as chronic fatigue syndrome (CFS), is a complex disease that includes the dysregulation of the Central Nervous system. There is no exact known etiology or pathophysiology which leads to the development of ME/CFS. To understand the possible causes behind this mysterious disease, I conducted this project under the guidance of Dr. Moslehi to evaluate a range of demographic, lifestyle, and epidemiological factors and their risk in the development of ME/CFS. Methods: My project is part of a case-control study conducted by Dr. Roxana Moslehi. ME/CFS is a rare disease, so a case-control study design was …

Evaluating Spatial Relationships Between Environmental Factors And Contextual Sociodemographic Burden And Associations With Respiratory Morbidity Among Young Children: An Indicator-Based Approach, Neil Anthony Muscatiello

Legacy Theses & Dissertations (2009 - 2024)

The body of public health literature related to air pollution epidemiology is extensive. Similarly, the body of literature related to social epidemiology has also expanded greatly in recent years. While studies in these sub-disciplines of epidemiology sometimes seek to control for variables more commonly studied in one or the other, fewer studies report on their combined effects. Studies which do attempt to summarize how the combined air pollution burden and contextual sociodemographic burden differentially effect health outcomes beyond their individual effects could be beneficial in understanding links between the environment and certain health outcomes such as childhood asthma. The proposed …

Gestational Epigenetic Aging : Prenatal Influences And Early Life Associations, Emilia Pawlowski

Legacy Theses & Dissertations (2009 - 2024)

Development Origins of Health (DOHaD) evidence suggests that prenatal exposures have an important impact on offspring health throughout the life course. Environmental and psychosocial exposures during fetal development are associated with a range of health outcomes for offspring, and effects are often sex specific. One of the mechanisms which may explain differences in health outcomes is epigenetic alterations, which are the molecular mechanisms that regulate gene expression and can be modified during fetal development. Many studies have shown that psychosocial stress and social adversity can modulate epigenetic mechanisms and affect health. While there are several methods for measuring epigenetic alterations, …

Examining The Association Between Childhood Adversity And Later Life Cardiometabolic Diseases, Shreya Shrinivas

Legacy Theses & Dissertations (2009 - 2024)

ACEs stands for Adverse Childhood Experiences, which are traumatic or stressful events that occur in childhood before the age of 18 (Wisner, 2022). These experiences can include physical, emotional, or sexual abuse; neglect; household dysfunction, such as parental separation, domestic violence, substance abuse, or incarceration; or exposure to community violence, racism, or discrimination. Research has shown that individuals who experience ACEs are at a higher risk for developing chronic diseases such as heart disease, diabetes, cancer, and mental health disorders later in life (Felitti, 2002). This is because ACEs can cause toxic stress, which is chronic activation of the stress …

Metabolic Alterations And Cardiovascular Risk After Hepatitis C Cure In Subjects With Or At Risk For Hiv, Christophe Maxime Fokoua Dongmo

Legacy Theses & Dissertations (2009 - 2024)

Background. Hepatitis C virus (HCV) infection engenders substantial metabolic changes. These changes are altered when the virus is cleared after successful treatment. We measured these metabolic alterations that occur after HCV cure; further, we assessed whether these alterations differed in subgroups defined by patients’ characteristics.

Evaluating The Health Impacts Of Fruit And Vegetable Intake At The Individual Level And Food Pantry Level Among Food Pantry Users, Jiacheng Chen

Legacy Theses & Dissertations (2009 - 2024)

Background: Chronic diseases impose heavy burdens on individuals and the healthcare system in the US. Many factors were found to be associated with chronic diseases, including demographics, family history, social environmental factors, and individual behavioral factors such as diet and physical activity. Among those factors, fruit and vegetable intake can have substantial health impacts via a variety of causal pathways. Fruit and vegetable (F&V) consumption is generally lower among individuals living in households experiencing food insecurity and rely on food assistance programs. Decreased F&V intake among food pantry users may negatively impact health. However, conducting quantitative analysis on this population …

Identifying Risk Factors For Hospitalization With Mental Illness And/Or Behavioral Disorders And Concurrent Temperature-Related Illness In New York State : A Cross-Sectional Study, Heather Aydin-Ghormoz

Legacy Theses & Dissertations (2009 - 2024)

Background: In New York State (NYS), extreme heat events in the warm months (May – September) are expected to increase over the next 60 years. Additionally, NYS experiences extremely low temperatures in the colder months (October – April). Extreme temperature events are linked to increased emergency department visits, hospitalizations, and mortality for individuals with mental and behavioral disorders. This research aims to characterize individual and regional risk factors for mental and behavioral disorder hospitalizations with concurrent temperature-related illness in NYS. Methods: Using data from the NYS Statewide and Planning Research and Cooperative System between 2005 – 2019, multivariate log binomial …

Environmental Factors And Human Health Interactions : Ultrafine Particles, Temperature Variability, And Proximity To Power Stations, Ian Ryan

Legacy Theses & Dissertations (2009 - 2024)

Background: Air pollution leads to more than four million premature deaths worldwide and nearly 200,000 in the US each year. While there is extensive research relating PM2.5 to hospital visits for various health outcomes, there is relatively little research on ultrafine particles (UFPs), a particularly small and dangerous air pollutant. Another important exposure is temperature due to its association with dehydration, heat stress, and cardiovascular-related hospital admissions. However, relatively little research has been conducted on diurnal temperature range (DTR), or the range of temperature within a single day, which is an important indicator of climate change. Importantly, the interaction between …

Disability In An American Indian Community : Prevalence, Distribution, And The Role Of Polychlorinated Biphenyls, Thoin Farzana Begum

Legacy Theses & Dissertations (2009 - 2024)

The Akwesasne reservation along the St. Lawrence River has experienced significant exposure to several persistent organic pollutants due to rapid industrialization. The Aluminum Company of America, General Motors, and Reynolds Metals operated aluminum foundries that used polychlorinated biphenyls (PCBs) as hydraulic fluids, which contaminated the community environment, the soil, air and water, and community food sources with PCBs. We administered the World Health Organization Disability Assessment Schedule II (WHODAS II) to 119 Akwesasne Mohawk adults residing along the St. Lawrence River in New York. We used exploratory factor analysis to summarize the 36- items comprising the WHODAS II. The 7 …

Association Between Antiretroviral Therapy And Severe Covid-19 Outcomes Among Hospitalized Hiv Positive People With Sars-Cov-2 In Nys, Aizhan Kyzayeva

Legacy Theses & Dissertations (2009 - 2024)

IMPORTANCE The role of antiretroviral therapy (ART) type in people living with HIV (PLWDH) co-infected with acute respiratory syndrome coronavirus 2 (SARS-Cov-2) remains unclear. There is evidence that certain classes of ART may mute the risk of severe COVID-19 outcomes.