Epidemiology Commons^™

The Association Between Dietary Inflammatory Index, Dietary Antioxidant Index, And Mental Health In Adolescent Girls: An Analytical Study, Parvin Dehghan, Marzieh Nejati, Amir Almasi-Hashiani, Sevda Saleh-Ghadimi, Rezza Parsi, Hamed Jafari-Vayghan, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd

Faculty Publications

Background Diet is considered as one of the modifiable factors that appears to exert a vital role in psychological status. In this way, we designed this study to examine the association between dietary inflammatory index (DII), dietary antioxidant index (DAI), and mental health in female adolescents. Methods This cross-sectional study included 364 female adolescents selected from high schools in the five regions of Tabriz, Iran. A 3-day food record was used to extract the dietary data and calculate DII/DAI scores. DII and DAI were estimated to assess the odds of depression, anxiety, and stress based on the Depression Anxiety Stress …

Quantile Differences In The Age-Related Decline In Cardiorespiratory Fitness Between Sexes In Adults Without Type 2 Diabetes Mellitus In The United States, Andrew Ortaglia, Melissa Stansbury, Michael David Wirth, Xuemei Sui, Matteo Bottai

Faculty Publications

Objective: To comprehensively assess the extent to which the decline in cardiorespiratory fitness (CRF) with age differs between sexes. Participants and Methods: This study used data from the Aerobics Center Longitudinal Study, conducted between September 1974 and August 2006, consisting primarily of White adults from middle-to-upper socioeconomic strata restricted to adults without type 2 diabetes mellitus (33,742 men and 9,415 women). Quantile regression models were used to estimate the differences in age-associated changes in CRF between the sexes, estimated using a maximal treadmill test. Results: For adults aged up to 45 years, significant differences in slopes relating to age and …

Changes Overtime In Perinatal Management And Outcomes Of Extremely Preterm Infants In One Tertiary Care Romanian Center, Diana Ungureanu, Nansi Boghossian, Laura Mihaela Suciu

Faculty Publications

Background and Objectives: Extremely preterm infants were at increased risk of mortality and morbidity. The purpose of this study was to: (1) examine changes over time in perinatal management, mortality, and major neonatal morbidities among infants born at 25⁰–28⁶ weeks’ gestational age and cared for at one Romanian tertiary care unit and (2) compare the differences with available international data. Material and Methods: This study consisted of infants born at 25⁰–28⁶ weeks in one tertiary neonatal academic center in Romania during two 4-year periods (2007–2010 and 2015–2018). Major morbidities were defined as any of …

Spotted Fever Group Rickettsioses In Central America: The Research And Public Health Disparity Among Socioeconomic Lines, Kyndall C. Dye-Braumuller, Marvin S. Rodriguez Aquino, Stella C.W. Self, Mufaro Kanyangarara, Melissa Nolan Ph.D., Mph

Faculty Publications

Tick-borne diseases including rickettsial diseases are increasing in incidence worldwide. Many rickettsial pathogens can cause disease which is commonly underdiagnosed and underreported; Rickettsia pathogens in the spotted fever group (SFGR) are thus classified as neglected bacterial pathogens. The Central American region shoulders a large proportion of the global neglected disease burden; however, little is known regarding SFGR disease here. Although development varies, four of the seven countries in this region have both the highest poverty rates and SFGR disease burdens (El Salvador, Honduras, Guatemala, and Nicaragua), compared to Belize, Panama, and Costa Rica. Utilizing the Human Development Index (HDI), we …

Capturing The Pool Dilution Effect In Group Testing Regression: A Bayesian Approach, Stella Self Ph.D., Ms, Christopher Mcmahan, Stefani Mokalled

Faculty Publications

Group (pooled) testing is becoming a popular strategy for screening large populations for infectious diseases. This popularity is owed to the cost savings that can be realized through implementing group testing methods. These methods involve physically combining biomaterial (eg, saliva, blood, urine) collected on individuals into pooled specimens which are tested for an infection of interest. Through testing these pooled specimens, group testing methods reduce the cost of diagnosing all individuals under study by reducing the number of tests performed. Even though group testing offers substantial cost reductions, some practitioners are hesitant to adopt group testing methods due to the …

Association Between Postpartum Weight Retention And The Dietary Inflammatory Index, Nyrobi Tyson

Theses and Dissertations

Objective: The objective of this thesis is to examine the relationship between the Dietary Inflammatory Index (DII), measured during the postpartum period, and postpartum weight retention.

Setting and Participants: We used the Infant Feeding Practices Study (IFPS) II (n=5000), a longitudinal study of women from late pregnancy through their infant’s first year of life conducted between 2005 and 2007. Survey topics included feeding practices, infant health, food allergies, sleeping arrangements, mother’s employment, childcare, and mother’s dietary intake.

Main Outcomes: Postpartum weight retention (PPWR) was calculated in kilograms by subtracting self-reported body weight at 3, 6, 9, and 12 months postpartum …

Rural-Urban Differences In Survival Among People With Early Onset Colorectal Cancer, Radhika Ranganathan

Theses and Dissertations

Colorectal cancer (CRC) is the third most common cancer and the second most among cancer deaths both in the US and globally. Early Onset Colorectal Cancer (EOCRC), occurring between the ages of 20 and 49, has continued to rise over the past decades. Several studies have reported a persistent increase in EOCRC incidence and mortality, especially in rural areas as compared to urban areas, despite decreases in rates for people over the age of 50 years. Increase in EOCRC may have played a role in lowering the age of screening recommendation to 45-49 age group. The objective of this study …

Unearthing An Emerging Neglected Bacterial Disease: Evidence Of Spotted Fever Group Rickettsioses In El Salvador, Kyndall Christian Braumuller

Theses and Dissertations

The main objectives of this dissertation were to investigate the seroprevalence of Spotted Fever Group Rickettsioses (SFGR) antibodies in a specific vulnerable population at high risk for vector-borne disease in El Salvador, understand the relevant risk factors for SFGR past and acute infection in this same population through logistic regression modeling, and clarify the presence of SFGR bacteria in locally collected ticks.

SFGR are a group of bacterial diseases caused by species in the Rickettsia genus of the phylogenetic spotted fever group. These are tick-borne diseases (TBD) that have been described in almost every region of the world. SFGR are …

Trajectories, Prevention Strategies, And Health Impacts Of Perinatal Depression, Sabrina Karim

Theses and Dissertations

Background

Perinatal depression is one of the most common and underdiagnosed obstetric complications. Extant research on perinatal depression is mostly focused on white women and women who are not at risk for depression. Little is known about the trajectories, prevention strategies and adverse outcomes of perinatal depression among high-risk populations, for example, women with overweight and obesity or women of color or low socioeconomic status.

Purpose

Our study examined the longitudinal trajectories of perinatal depression, effect of a behavioral lifestyle intervention on perinatal depression and association between prenatal physical activity and perinatal depression among women with overweight and obesity. We …

Association Between The Dietary Inflammatory Index And Gastric Disease Risk: Findings From A Korean Population-Based Cohort Study, Sundara Raj Sreeja, Trong-Dat Le, Bang Wool Eom, Seung Hyun Oh, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Mi Kyung Kim

Faculty Publications

Evidence suggests that diets with high pro-inflammatory potential may play a substantial role in the origin of gastric inflammation. This study aimed to examine the association between the energy-adjusted dietary inflammatory index (E-DIITM) and gastric diseases at baseline and after a mean follow-up of 7.4 years in a Korean population. A total of 144,196 participants from the Korean Genome and Epidemiology Study_Health Examination (KoGES_HEXA) cohort were included. E-DII scores were computed using a validated semi-quantitative food frequency questionnaire. Multivariate logistic regression and Cox proportional hazards regression were used to assess the association between the E-DII and gastric disease risk. In …

Adolescent Health Risk Behaviors, Adverse Experiences, And Self-Reported Hunger: Analysis Of 10 States From The 2019 Youth Risk Behavior Surveys, Kathryn L. Krupsky, Sarah Silwa, Hilary Seligman, Andrea D. Brown, Angela D. Liese Ph.D., Zewditu Demissie, Ellen Barnidge

Faculty Publications

We examined associations between adolescent self-reported hunger, health risk behaviors, and adverse experiences during the 2018–2019 school year. Youth Risk Behavior Survey data were pooled from 10 states. Prevalence ratios were calculated, and we assessed effect measure modification by sex. The prevalence of self-reported hunger was 13%. Self-reported hunger was associated with a higher prevalence of every health risk behavior/adverse experience analyzed, even after adjusting for sex, grade, and race/ethnicity. Sex did not modify associations. Findings underscore needs for longitudinal research with more robust measures of adolescent food insecurity to clarify the temporality of relationships.

Factors Associated With Covid-19 Vaccine Intentions Among South Carolina Residents, Mufaro Kanyangarara, Lauren Mcabee, Virginie G. Daguise, Melissa Nolan Ph.D., Mph

Faculty Publications

Despite evidence of vaccine safety and efficacy, vaccine hesitancy remains a major global health threat. The COVID-19 vaccine has presented unique vaccine hesitancy concerns compared to parental vaccine hesitancy towards childhood vaccines. South Carolina (SC) is home to a largely conservative population and historically has some of the lowest vaccination coverage rates in the United States of America. The goal of the current study was to identify factors associated with COVID-19 vaccine intentions among SC residents. From November 2020 to September 2021, 300,000 invitations to participate in community testing and complete an online survey were mailed to randomly selected SC …

A Preliminary Study Of Proinflammatory Cytokines And Depression Following West Nile Virus Infection, Allison Lino, Timothy A. Erickson, Melissa Nolan Ph.D., Mph, Kristy O. Murray, Shannon E. Ronca

Faculty Publications

West Nile virus (WNV) is a neurotropic flavivirus that can cause acute febrile illness leading to neuroinvasive disease. Depression is a well-described outcome following infection, but the underlying pathogenic mechanisms are unknown. Proinflammatory cytokines play important roles in WNV infection, but their role in depression post-WNV remains unstudied. This research aimed to retrospectively evaluate associations between proinflammatory cytokines and new onset depression in a WNV cohort. Participants with asymptomatic WNV infection were significantly less likely to report new onset depression when compared to those with symptomatic disease. Participants with encephalitis and obesity were significantly more likely to report new onset …

Are Pregnant Women With Disability Prescribed Opioids More And At Higher Dosages Than Those Without Disability?: A Retrospective Cohort Study Of South Carolina Medicaid Beneficiaries, Chelsea L. Richard Phd, Msph, Bryan L. Love Pharm.D., Nansi Boghossian, James Hardin Ph.D., Suzanne Mcdermott

Faculty Publications

Background: Nationally, individuals with disability have higher rates of opioid use and misuse and are prescribed higher doses than those without disability. Opioid prescriptions during pregnancy are associated with adverse birth outcomes. Objective: To understand the difference in opioid prescribing during pregnancy over time by disability status among Medicaid beneficiaries who gave birth from 2008 to 2017 in South Carolina. Methods: Data from hospital discharges, vital records, and pharmacy were linked to determine the mother's disability status, opioid prescriptions filled during pregnancy, and other maternal characteristics. Disability status was characterized into physical disability, inflammatory conditions, intellectual and developmental disabilities (IDD), …

Food Insecurity And Suicidal Behaviors Among Us High School Students*, Andrea D. Brown, Hilary Seligman, Sarah Silwa, Ellen Barnidge, Kathryn L. Krupsky, Zewiditu Demissie, Angela D. Liese

Faculty Publications

BACKGROUND: Food insecurity (FI) rates in the United States are particularly high among households with children. This research set aims to analyze if high school students experiencing FI had higher risk for mental health and suicidal behaviors.

METHODS: Using combined data from 11 states that conducted the 2017 Youth Risk Behavior Survey, a total of 26,962 and24,051 high school students were used to estimate race/ethnicity and sex-stratified prevalence ratios (PRs) from Poissonregression models. A single-question was used to measure the exposure of FI and outcomes of mental health and suicidalbehaviors.

RESULTS: Overall, 10.8% of students reported FI. Students experiencing FI …

Needs Assessment Of Southeastern United States Vector Control Agencies: Capacity Improvement Is Greatly Needed To Prevent The Next Vector-Borne Disease Outbreak, Kyndall C. Dye-Braumuller, Jennifer R. Gordon, Danielle John, Josie Morrissey, Kaci Mccoy, Rhoel R. Dinglasan, Melissa Nolan Ph.D., Mph

Faculty Publications

A national 2017 vector control capacity survey was conducted to assess the United States’ (U.S.’s) ability to prevent emerging vector-borne disease. Since that survey, the southeastern U.S. has experienced continued autochthonous exotic vector-borne disease transmission and establishment of invasive vector species. To understand the current gaps in control programs and establish a baseline to evaluate future vector control efforts for this vulnerable region, a focused needs assessment survey was conducted in early 2020. The southeastern U.S. region was targeted, as this region has a high probability of novel vector-borne disease introduction. Paper copies delivered in handwritten envelopes and electronic copies …

Shining A Light On Marginal Food Insecurity In An Understudied Population Comment, Angela D. Liese

Faculty Publications

No abstract provided.

The Critical Value Of Maternal And Child Health (Mch) To Graduate Training In Public Health: A Framework To Guide Education, Research And Practice Comment, Julianna Deardorff, Michelle Menser Tissue, Patricia Elliott, Arden Handler, Cheryl Vamos, Zobeida Bonilla, Renee Turchi, Cecilia Sem Obeng, Jihong Liu, Holly Grason

Faculty Publications

Introduction

In light of persistent health inequities, this commentary describes the critical role of maternal and child health (MCH) graduate training in schools and programs of public health (SPPH) and illustrates linkages between key components of MCH pedagogy and practice to 2021 CEPH competencies.

Methods

In 2018, a small working group of faculty from the HRSA/MCHB-funded Centers of Excellence (COEs) was convened to define the unique contributions of MCH to SPPH and to develop a framework using an iterative and consensus-driven process. The working group met 5 times and feedback was integrated from the broader faculty across the 13 COEs. …

Dietary Score Associations With Markers Of Chronic Low-Grade Inflammation: A Cross-Sectional Comparative Analysis Of A Middle- To Older-Aged Population, Seán R. Miller, Pilar Navarro, Janas M. Harrington, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Ivan J. Perry, Catherine M. Phillips

Faculty Publications

Purpose

To assess relationships between the Dietary Approaches to Stop Hypertension (DASH), Mediterranean Diet (MD), Dietary Inflammatory Index (DII^®) and Energy-adjusted DII (E-DII™) scores and pro-inflammatory cytokines, adipocytokines, acute-phase response proteins, coagulation factors and white blood cells.

Methods

This was a cross-sectional study of 1862 men and women aged 46–73 years, randomly selected from a large primary care centre in Ireland. DASH, MD, DII and E-DII scores were derived from validated food frequency questionnaires. Correlation and multivariate-adjusted linear regression analyses with correction for multiple testing were performed to examine dietary score relationships with biomarker concentrations.

Results

In fully …

Pro-Inflammatory Diet Pictured In Children With Atopic Dermatitis Or Food Allergy: Nutritional Data Of The Lina Cohort, Olivia Schütte, Larissa Bachmann, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Janine F. Felix, Stefan Röder, Ulrich Sack, Michaek Borte, Wieland Kiess, Ana C. Zenclussen, Gabriele I. Stangl

Faculty Publications

Background: Lifestyle and environmental factors are known to contribute to allergic disease development, especially very early in life. However, the link between diet composition and allergic outcomes remains unclear. Methods: In the present population-based cohort study we evaluated the dietary intake of 10-year-old children and analyses were performed with particular focus on atopic dermatitis or food allergy, allergic diseases known to be affected by dietary allergens. Dietary intake was assessed via semi-quantitative food frequency questionnaires. Based on these data, individual nutrient intake as well as children’s Dietary Inflammatory Index (C-DII™) scores were calculated. Information about atopic manifestations during the first …

Dietetic Intervention In Psoriatic Arthritis: The Dieta Trial, Beatriz F. Leite, Melissa A. Morimoto, Carina M. F. Gomes, Barbara N.C. Klemz, Patrícia S. Genaro, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Nágila R.T. Damasceno, Marcelo M. Pinheiro

Faculty Publications

Aim To evaluate whether dietary pattern changes, antioxidant supplementation or 5-10% weight loss could improve disease activity (skin and joint) in patients with psoriatic arthritis (PsA). Methods A total of 97 PsA patients were enrolled in this 12-week randomized, double-blinded, placebo-controlled trial. Patients were randomized into three groups: Diet-placebo (hypocaloric diet + placebo supplementation); Diet-fish (hypocaloric diet + 3 g/day of omega-3 supplementation; and Placebo. Food intake (3-day registry, Healthy Eating Index (HEI), and the Dietary Inflammatory Index (DII)), body composition (whole-body dual-energy X-ray absorptiometry (DXA), weight and waist circumference) and disease activity (PASI, BSA, BASDAI, DAS28-ESR, DAS28-CRP and MDA) …

“Pandemias Políticas: The Effects Of Political And Social Instability On Infectious Disease Epidemiology In Latin America"”, Sarah H. Noonan

Senior Theses

This paper seeks to analyze the relationship between political and social unrest and conflict and infectious disease epidemiology in Latin America. An analysis of published literature regarding epidemiological, biomedical, political, and historical content was conducted to highlight potential connections between infectious disease epidemics and sociopolitical conflict in the region. Specific analyses of Smallpox, Venezuelan Equine Encephalitis, Chagas disease, Cholera, Dengue, and COVID-19 were conducted, in an effort to uncover potential causations and context of epidemics of these conditions. Results of this analysis depict a necessity for further research into public health and disease control mechanisms during times of conflict and …

The Age Of E-Cigarette Initiation And Association With Frequency Of Use And Risk Of Combustible Tobacco Cigarette Smoking Initiation, Andy Hu

Senior Theses

Background - Studies have shown that electronic nicotine delivery systems (ENDS) are unsafe for consumption. However, the prevalence of e-cigarette use among adolescents and young adults continues to increase, which is being addressed by research. Little attention has been paid to the effects of earlier age of ENDS initiation.

Purpose - This paper examined published research studies on the topic of the age of initiation of e-cigarette use in relation to 1) frequency of e-cigarette use and 2) risk of combustible tobacco cigarette smoking initiation. This research tested the hypothesis that an earlier age of e-cigarette initiation was associated with …

Associations Among Plant-Based Dietary Indexes, The Dietary Inflammatory Index, And Inflammatory Potential In Female College Students In Saudi Arabia: A Cross-Sectional Study, Ghadeer S. Aljuraiban, Rachel Gibson, Leenah Al-Freeh, Sara Al-Musharaf, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert, Linda M. Oude, Queenie Chan

Faculty Publications

Background Saudi Arabian diets are transitioning to more Western dietary patterns that have been associated with higher levels of inflammation. Emerging evidence suggests plant-based diets are related to lower levels of inflammation; however, the definition of plant-based diets varies. Objective The purpose of this study was to identify the extent to which an overall Plant-Based Diet Index (PDI), Healthy-PDI (hPDI), and Unhealthy-PDI (uPDI) vs Energy-Adjusted Dietary Inflammatory Index correlate with high-sensitivity C-reactive protein (hs-CRP) level. Design This was a cross-sectional study carried out at King Saud University. Data on dietary intake, anthropometrics, and hs-CRP were collected. Participants/setting Female students aged …

The Impact Of Cannabis And Alcohol Use On The Management Of Type 1 Diabetes Mellitus, Joshua Eric Sellner

Theses and Dissertations

This dissertation sought to contribute to the evidence-base of diabetes management and acute complications associated with alcohol and cannabis use among individuals with Type 1 Diabetes (T1DM). Three interconnected studies were initiated to complete this goal. First, existing literature surrounding the potential consequences of cannabis consumption among individuals with T1DM were summarized within a systematic review. Study results were combined to provide a single measure of association through a meta-analysis. Second, identified associations were further investigated through a cross-sectional study using the SEARCH for Diabetes in Youth data on alcohol and cannabis use on diabetes management and acute complications including …

Bright Light Treatment Of Combat-Related Ptsd: A Randomized Controlled Trial, Shawn D. Youngstedt, Christopher E. Kline, Alexandria Reynolds, Shannon K. Crowley, James B. Burch Ph.D., Nidha Khan, Seungyong Han

Faculty Publications

Introduction

Post-traumatic stress disorder (PTSD) is a prevalent consequence of combat with significant associated morbidity. Available treatments for PTSD have had limitations, suggesting a need to explore alternative or adjuvant treatments. Numerous rationales for bright light treatment of PTSD include its benefits for common PTSD comorbidities of depression, anxiety, and circadian misalignment and its relative ease of use with few side effects. The primary aims of this research were to examine the effects of bright light treatment for combat-related PTSD and associated morbidity. Materials and Methods

A randomized controlled trial was performed in N = 69 veterans with PTSD attributable …

Longitudinal Relation Of Dietary Quality And Hemoglobin A1c In Youth And Young Adults With Diabetes, Hope Bercaw

Theses and Dissertations

Background Hemoglobin A1c (HbA1c) is a clinical measure of glycemic control among people with diabetes and is associated with health outcomes such as cardiovascular disease. It is possible to decrease HbA1c by improving diet, but it is largely unknown which dietary components are most important in targeting glycemic control.

Objective This study aims to examine whether changes in diet quality across diabetes duration, assessed with the 2015-Healthy Eating Index (HEI), are associated with HbA1c in youth and young adults (YYA) with type 1 (T1D) and type 2 diabetes (T2D). Additionally, we aim to assess whether these relationships differ when dietary …

Associations Of The Fto Gene And Risk Of Acute Myeloid Leukemia, Avery Ulrich

Theses and Dissertations

Background Acute Myeloid Leukemia (AML) is a blood cancer that affects ~70,000 people each year in the US. The Fat Mass and Obesity (FTO) gene on chromosome 16 has been reported to be associated with obesity, solid tumor cancers (lung, renal, breast, prostate, pancreatic, endometrial), and more recently with hematologic malignancies, like AML. In this thesis, we test the hypothesis that inherited variants within the FTO gene are associated with an increased risk of AML. Methods Using the DISCOVeRY-BMT (Determining the Influence of Susceptibility COnveying Variants Related to one-Year mortality after Blood and Marrow Transplantation), a well-powered genome-wide association study …

Television Viewing Time And All-Cause Mortality: Interactions With Bmi, Physical Activity, Smoking, And Dietary Factors, Christopher T. Swain, Julie K. Bassett, Allison M. Hodge, David W. Dunstan, Neville Owen, Yi Yang, Harindra Jayasekara, James R. Hébert Scd, Nitin Shivappa Mbbs, Mph, Ph.D., Robert J. Macinnis, Roger L. Milne, Dallas R. English, Brigid M. Lynch

Faculty Publications

Background Higher levels of time spent sitting (sedentary behavior) contribute to adverse health outcomes, including earlier death. This effect may be modified by other lifestyle factors. We examined the association of television viewing (TV), a common leisure-time sedentary behavior, with all-cause mortality, and whether this is modified by body mass index (BMI), physical activity, smoking, alcohol intake, soft drink consumption, or diet-associated inflammation. Methods Using data from participants in the Melbourne Collaborative Cohort Study, flexible parametric survival models assessed the time-dependent association of self-reported TV time (three categories: < 2 h/day, 2-3 h/day, > 3 h/day) with all-cause mortality. Interaction terms were fitted to test whether …

Determinants Of Covid-19 Vaccinations Among A State-Wide Year-Long Surveillance Initiative In A Conservative Southern State, Lídia Gual-Gonzalez, Maggie S.J. Mccarter, Kyndall Dye-Braumuller, Stella Self, Connor H. Ross, Chloe Rodriguez-Ramos, Virginie G. Daguise, Melissa Nolan Ph.D., Mph

Faculty Publications

By the end of 2021, the COVID-19 pandemic resulted in over 54 million cases and more than 800,000 deaths in the United States, and over 350 million cases and more than 5 million deaths worldwide. The uniqueness and gravity of this pandemic have been reflected in the public health guidelines poorly received by a growing subset of the United States population. These poorly received guidelines, including vaccine receipt, are a highly complex psychosocial issue, and have impacted the successful prevention of disease spread. Given the intricate nature of this important barrier, any single statistical analysis methodologically fails to address all …