Epidemiology Commons^™

Latent Tuberculosis Infection Treatment Completion And Predictors Of Noncompletion Among Visa Holders In The Rural Setting, Scott Hutton

Walden Dissertations and Doctoral Studies

Latent tuberculosis infection (LTBI), a product of exposure to Mycobacterium tuberculosis (Mtb), can lead to tuberculosis (TB) and further cause death if untreated. Fortunately, TB can be prevented with LTBI treatment. Targeting newly arrived visa holders for LTBI screening and treatment is an effective strategy for decreasing future TB burden. However, LTBI treatment completion rates are low, and researches had primarily focused on the nonrural U.S. setting. This study, using a retrospective cohort design under the epidemiological disease triangle framework evaluated (a) the treatment completion rates for 2 cohorts of visa holders (i.e., immigrants, N = 31 and refugees, N …

How Fine Particulate Matter Modifies Preterm Birth Risks In Korea, Hyun Jin Choi

Walden Dissertations and Doctoral Studies

Despite the increasing interest in preterm birth risk associated with maternal exposure to the current level of fine particulate matter (PM2.5) in Korea, there is little information on differences in PM2.5 exposure and its impact on preterm birth. This study was designed to examine the effects of Korea's air quality on preterm birth, including the possibility of moderation and mediation. This work was also designed to investigate manipulable factors for PM2.5 exposure. The theoretical framework of this quantitative and observational study included the social ecological theory and systems theory. The conceptual framework of this partially ecologic and retrospective cohort study …

Bleach-It-Away Clostridium Difficile, Kim Ione Hecker

Walden Dissertations and Doctoral Studies

Hospital-associated infections (HAIs) are infections patients contract as a result of being hospitalized. HAI rates decreased for almost all pathogens in the past few years, with the exception of Clostridium difficile infections (CDIs), which have been steadily climbing, placing hospital-acquired CDI at the top of the HAI list. The Center for Disease Control and Prevention reported in 2010 almost a half a million people were infected with CDIs yearly in the United States, and CDIs claimed the lives of approximately 29,000 people, representing a 4-fold increase from 1993. To address the problem in the local hospital, a quality improvement initiative …

Evaluating Parents' Decisions Regarding Recommended Childhood Vaccinations, Jennifer Kline

Walden Dissertations and Doctoral Studies

Vaccinations are among the greatest accomplishments of public health. However, many parents are choosing not to vaccinate. The purpose of this study was to explore the association between social media influence and parents' decisions to vaccinate their children. The health belief model indicates that individuals' likelihood of engaging in a health-related behavior is determined by their perceptions of susceptibility, severity, benefits, and barriers. The research questions addressed whether there is an association between parents' perception of their children's disease susceptibility and their decisions about vaccination, and whether there is an association between exposure to messaging from social media and parents' …

Household Determinants Of Malaria In Mutasa District Of Zimbabwe, David Takudzwa Zinyengere

Walden Dissertations and Doctoral Studies

Malaria is a vector borne, acute febrile illness, caused by Plasmodium parasites. Malaria impacts the medical and socioeconomic development programs of affected communities, as it diverts both individual and national resources into managing the disease burden. The purpose of this study was to explore and evaluate household determinants of malaria in Mutasa District, Zimbabwe. The precede-proceed theoretical model guided the study. Secondary data from Demographic Health Survey and District Health Management Information System, and current data from household determinant questionnaires, were used to evaluate the influence and significance of identified household determinants. Multiple logistic regression models were used to examine …

Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner

Walden Dissertations and Doctoral Studies

Insulin resistance is an increasing public health issue with the current literature, suggesting reduced sensitivity of insulin leads to adult onset diabetes and associated downstream pathologies that reduce life expectancy. The main objectives of this study were to evaluate the ability of the Oral Glucose Insulin Secretion Test (OGIST) to identify insulin resistance and examine differences in the insulin sensitivity based on gender, age, and ethnicity. This study was supported by the insulin resistance theory which focuses on the reduced ability of insulin to bind to the cellular insulin receptor, reducing the sensitivity of insulin. The OGIST lab results of …

Emergency Department Use For Nontraumatic Dental Conditions And Adult Oral Health, Cheryl Anne Lassiter-Edwards

Walden Dissertations and Doctoral Studies

Nontraumatic dental-related emergency department visits has resulted in a financial burden to hospitals across the United States. This study investigated whether there is a relationship between adult preventive dental care and emergency department visits for nontraumatic dental conditions by comparing specific states. Guided by Andersen's behavioral model of health services utilization, this retrospective quantitative study also investigated associations between state-specific community water fluoridation and dental-related emergency department visits. The population of interest was adult Medicaid enrollees who visited the emergency department for non-trauma-related dental conditions in the top 5 most populous states as identified in the 2012 NHAMCS survey. These …

Early Radiation Therapy And Cervical Cancer Survival In The United States, Olufunmiso Oyetunde Asamu

Walden Dissertations and Doctoral Studies

A paucity of information exists on the benefits of using radiation therapy for treating women with early cervical cancer detection. The purpose of this cross-sectional study was to investigate the association between early versus late testing of Human papilloma virus (HPV), age, race, radiation therapy, and regions in United States, and survival rates among women diagnosed with early cervical cancer. The epidemiological triad of person, time, and space guided this study to explain the regional spread of cervical cancer, and the effect of early testing. Secondary data from Surveillance, Epidemiology, and End Results (SEER) were used (N= 520,153). Statistical analyses …

Association Between Genetic Ancestry And Body Mass Index Among A Cohort Of Hispanic American Children, Sahel Hazrati

Walden Dissertations and Doctoral Studies

Childhood obesity is disproportionately higher among children from Hispanic backgrounds. Ethnicity is a social and cultural construct and does not capture true ancestral heterogeneity. Hispanic Americans have a wide variety of genetic admixture proportions of European (EUR), Native American (AMR), and African (AFR) ancestry. The objective of this cross-sectional study was to assess the contribution of ancestral genetic composition to body mass index (BMI), and to evaluate the relationship of obesity risk factors to BMI among 154 2-year-old Hispanic American children. The theory of Evolutionary Developmental Biology was utilized to investigate the relationship between children's growth process and ancestral background. …

Predictive Relationship Between Treatment Adherence, Glycated Hemoglobin And Diabetic Complications Among Jamaicans, Christian Anaba Nwaukwa

Walden Dissertations and Doctoral Studies

Patient nonadherence to physicians' prescribed therapeutic regimen is the greatest challenge in the effective treatment of patients with diabetes worldwide. Scientific evidence has revealed that nonadherence to prescribed medication could result in diabetic complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathic diabetic foot ulcers. The purpose of this study was to explore predictive relationships between levels of adherence to antidiabetic medications, patient HbA1c levels, and diabetic complications among Jamaicans, an understudied population. The research question that guided this study was: Do the patient level of adherence and HbA1c levels have any predictive relationship with the severity of diabetic complications …

Association Between Androgen Deprivation Therapy For Prostate Cancer And Alzheimer's Disease, Gina Giannantoni-Ibelli

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is the most common progressive, neurodegenerative disease and form of dementia. The hallmarks of AD are extracellular accumulation of amyloid beta protein, resulting in neuritic, senile plaques and intracellular accumulation of tau protein. AD mainly arises from imbalance of amyloid beta protein production and its clearance in the brain. Testosterone modulates production of amyloid beta protein by decreasing its accumulation. Prostate cancer remains a substantial public health challenge in the United States. While androgen deprivation therapy (ADT) is an effective treatment for prostate cancer, it may be associated with cognitive impairment due to decreased levels of testosterone. …

Poverty Rate And Occurrence Of Foodborne Illness Risk Factors In Retail Facilities, Margolite Joseph Cesar

Walden Dissertations and Doctoral Studies

Despite the efforts of food safety regulations and rules, food contamination remains a public health concern and prevalent vehicle of pathogens. This study identifies the predictors of food risk in different types of food establishments in Miami Dade County, Florida during the period November 2014 - November 2016. Guided by the epidemiologic triangle model, this correlational study analyzed the log number of risk factor violations and failure rates controlling for US Census sociodemographic data (2010 to 2014) for the food establishment neighborhoods by using linear and logistic regression. Results indicated that most of food entity types are significant predictors of …

The Relationship Of Location And Educational Achievements To Vision Impairment In Asians, Sonali Trivedi

Walden Dissertations and Doctoral Studies

Introduction: Increasing incidence of vision impairment in the United States reinforces the urgent need for research and public health awareness. Eye diseases are of common concern in Asian and other ethnic groups globally. Glaucoma, cataracts, macular degeneration, myopia, and retinitis are types of eye diseases and common causes of vision impairment in Asians. This study addressed the current gap in knowledge regarding vision impairment prevalence among Asian-Americans by geographical location and level of education. Socio-ecological theory was used as the theoretical foundation.

Method: A cross-sectional secondary dataset from U.S. Census Bureau included 3,916,947 participants' survey responses from 2011 through 2015 …

Relationship Between Exposure To Phthalate And Obesity In The United States, Gladys Chidiebere Ezem

Walden Dissertations and Doctoral Studies

Obesity is a public health problem. The global obesity problem has been attributed to unhealthy diet, inactivity, and hereditary factors. However, phthalates may also contribute to the obesity epidemic. The purpose of this cross-sectional study was to examine whether there was a relationship between exposure to phthalates and obesity among adults 18 years and older in the United States. The theoretical framework was based on the socioecological model. The quantitative, cross-sectional design, and data analysis were based on the National Health and Nutrition Examination Survey, 2011-2012 database. Descriptive statistics and multiple regression analysis were used to analyze the association between …

Factors Affecting Colorectal Cancer Screening Among African-Born Immigrants In The United States, Chidoziri Chibundu

Walden Dissertations and Doctoral Studies

Despite the evidence that colorectal cancer screening is effective in reducing the incidence of and mortality from colorectal cancer, racial and ethnic disparities in colorectal cancer screening persist in the United States. African-born immigrants in the United States have lower colorectal cancer screening rates than native-born Americans. The purpose of this quantitative, retrospective, cross-sectional study was to examine how family income, health insurance status, language of interview, length of stay in the United States, perceived health status, level of education, and having a usual place for medical care affect colorectal cancer screening among African-born immigrants in the United States. The …

Public Health Strategies For Strengthening Prehospital Injury Responses In St. Lucia, Delwin Oliver Ferguson

Walden Dissertations and Doctoral Studies

Traumatic injuries have steadily increased during the last two decades, affecting over 5.8 million persons annually and have become a global public health issue. Since 2008, 80% of all deaths from noncommunicable diseases and trauma, approximately 29 million occurred in developing countries. Sixteen thousand young adults worldwide have died due to traumatic injuries. Additionally, injuries account for over 15% of the global burden of diseases, with approximately 90% of these injuries occurring in developing countries like St. Lucia. The purpose of this qualitative descriptive study was to examine policy gaps in prehospital traumatic injury responses and explore implementing Essential Public …

Diabetic Adult Access To Medical Care And Race And Ethnicity In Connecticut, Natacha Bertine Jerome

Walden Dissertations and Doctoral Studies

Diabetes is among the leading causes of death in Connecticut. An approximate of 330,000 adults in Connecticut have diabetes (diagnosed and undiagnosed). Those with diabetes have almost twice the risk of premature death throughout various age groups. The purpose of this cross-sectional study was to investigate whether disparities exist in access to medical care due to race and ethnicity; among adults with diabetes in the state of Connecticut. Furthermore, this study used the Andersen's behavioral model framework. Survey data from the behavioral risk factor surveillance system (BRFSS) were also analyzed. The research study covered 3 years (2013 to 2015) of …

Relationships Among Vitamin D Deficiency, Metabolic Syndrome, Smoking Behavior, And Physical Activity, Ethan Pham

Walden Dissertations and Doctoral Studies

Aging increases the risk of both vitamin D deficiency and metabolic syndrome. Vitamin D deficiency and metabolic syndrome may be related, although there are mixed findings. Furthermore, literature suggests other factors such as physical fitness activity and smoking behavior are associated with Vitamin D deficiency and the development of metabolic syndrome. A number of studies have documented associations between Vitamin D levels and physical fitness activities, while other studies found correlations between Vitamin D levels, metabolic syndrome, and smoking behavior. However, no previous study has examined the links between physical fitness activity, smoking behavior, Vitamin D levels, and the risks …

Sleep Quality And Its Health Correlates Among Egyptian Secondary School Students, Dalia M. Ismail, Dalia G. Mahran, Ali H. Zarzour, Ghaydaa A. Sheahata

Journal of Social, Behavioral, and Health Sciences

The objective of the recent study was to determine the prevalence of poor sleep quality and to assess its psychological and general health correlates among secondary school students in the city of Assiut, Egypt. A cross sectional study was conducted among 829 secondary school students (selected by multistage stratified random sampling) aged 15–19 years in Assiut. Students filled in a self-administered questionnaire that included demographic data, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, general perception of health, and the short form of Depression Anxiety and Stress Scale. The prevalence of poor sleep quality (PSQI >5) was 72.5%. The mean …

The Role Of Inflammatory Biological Markers In Novel Pharmacotherapies For Populations With Depression, Stacey Boyer

Walden Dissertations and Doctoral Studies

Current interventional pharmaceutical therapies targeted for depression are not adequate to achieve sufficient remission following treatment. Researchers explored inflammatory biomarkers as a way of understanding why treatment for depression is effective for some and not others. The purpose of this secondary data analysis study was to determine if there was a relationship between inflammatory biomarkers and treatment efficacy in persons diagnosed with depression who have demonstrated a previous lack of remission. Using the immune-cytokine paradigm of depression (POD) allowed depression to be viewed as multifaceted and a potential signal of chronic immune system activation. This secondary data analysis included findings …

Association Between Age-Related Macular Degeneration And Sleep-Disordered Breathing, Jeffrey A. Nau

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is a chronic, irreversible disease that robs individuals of vision, quality of life, and independence. It is the leading cause of blindness in industrialized countries. Sleep-disordered breathing (SDB) is a condition characterized by repeated episodes of apnea and/or hypopnea, insomnia, short sleep duration, and/or sleep disturbances (snoring, gasping, etc.). Because SDB has been shown to cause chronic hypoxia resulting in oxidative stress on the retina, it has been proposed that SDB may be associated with AMD. Based on the life course theory of chronic disease, this quantitative, cross-sectional study used data from the 2005-2008 National Health …

How Parenting Behaviors Influence Weight And Health Status Of African American Adolescents, Natasha T. Hourel

Walden Dissertations and Doctoral Studies

There has been an upward trend in obesity among African American (AA) adolescents over the last 2 decades. While parenting characteristics (e.g., styles and practices) are linked to adolescent eating habits and weight status, related research has focused on European American children from 2-parent middle-class households or economically disadvantaged AA children from single mother households. The purpose of this quantitative secondary data analysis was to investigate the relationship between parenting characteristics on the weight status of adolescents aged 12 to 17 years (n = 325) among a broader population of AA mothers and fathers residing both inside and outside of …

The Association Between Medical Marijuana Laws And Maternal Marijuana Use, Joseph Timothy Jones

Walden Dissertations and Doctoral Studies

Marijuana is the most common illicit drug that is abused by pregnant women, and recently many states have adopted various levels of relaxed marijuana policies. The purpose of this study was to evaluate a potential association between residing in a state that allows medical marijuana use and maternal marijuana usage. Grounded in the theory of planned behavior, this study evaluated the prevalence and extent of maternal marijuana use in states that allow and states that do not allow medical marijuana use using the National Survey of Drug Use and Health (NSDUH). It was anticipated that more lenient subjective norms toward …

Gender Inequality In Women's Knowledge And Awareness Of Hiv/Aids In Port Harcourt, Maureen A. Wagbara

Walden Dissertations and Doctoral Studies

In Nigeria, gender inequality significantly impacts women's knowledge and awareness of the transmission of the human immunodeficiency virus (HIV) and the proliferation of acquired immunodeficiency syndrome (AIDS). Early marriage, traditional beliefs, religion, and polygamy all contribute to gender inequality. This study explored the role of these and other sociocultural practices in the gender inequalities that increase vulnerability of contracting HIV/AIDS among women in Port Harcourt, Rivers State, Nigeria. The study employed a phenomenological design, collected data through a semistructured interview approach, which was managed using NVivo software. The purposive sample comprised 20 female students from a college in Port Harcourt. …

Serum Iron Concentration And Prostate Cancer In The United States, Aleeshaia Danner Raymonvil

Walden Dissertations and Doctoral Studies

Over 2 million adult men in the United States have been diagnosed with prostate cancer, with nearly 200,000 new diagnoses each year. This type of cancer is the leading cause of mortality in U.S. men. One possible risk factor for prostate cancer is a high level of iron in the body, but the association has yet to be confirmed. This study was an investigation of the relationship between serum iron concentration and prostate cancer using data obtained from the 2009-2012 National Health and Nutrition Examination Surveys. This quantitative study involved 1,850 men in the U.S. aged 51 to 70 years. …

Using Administrative Healthcare Records To Identify Determinants Of Amputee Residuum Outcomes, Judith Gail Walden

Walden Dissertations and Doctoral Studies

In the United States, the number of major limb amputees is predicted to exceed several million in the coming decades. For those amputees using a prosthesis, their quality of life (QoL) is often modulated by residuum limb problems resultant from its use. Multiple factors preclude quality evidence-based medicine (EBM) research in the field of prosthetics, leading to greater health risk from prosthetic prescription ambiguity. Positive social change is integral to good QoL; studies support administrative healthcare (AHc) as useful to support such, especially in the absence of EBM. This study utilized Veterans Healthcare Administration (VHA) AHc data to discriminate determinants …

The Impact Of Palliative Care On Health Status In Hiv-Positive Children, Aabid Abdulmajid Ahmed

Walden Dissertations and Doctoral Studies

HIV-positive children in sub-Saharan Africa have numerous challenges to overcome. These challenges increase psychosocial stress as well as symptom burden including fatigue, weight loss, pain, and mental changes. The symptoms may persist even after initiation of antiretroviral therapy, so such children need additional care. Palliative care lays emphasis on holistic patient-centered care, including physical, psychological, social, and spiritual symptoms, alongside antiretroviral therapy. There is limited data on the impact of integrating palliative care with standard HIV care and treatment in children. The purpose of this study was to fill the gap in the literature by investigating the impact of palliative …

Relationship Between Quality Of Life For Patients With Neuroendocrine Tumors And Novel Biomarkers, Stephanie L. Ford-Scheimer

Walden Dissertations and Doctoral Studies

Research in the field of neuroendocrine tumors (NETs) has increased over the last decade, including studies focused on biochemical markers (biomarkers) of the disease. There is also growing interest in how NETs impact patients' quality of life (QOL). Consequently, there is a paucity of information about whether the expression of the specific disease biomarkers affects QOL as well as whether the primary tumor site impacts QOL. Using the explanatory model of health promotion and quality of life in chronic disabling conditions as the theoretical framework and data collected with the Norfolk QOL-NET instrument, this study's purpose was to fill that …

Exploring The Role Of Faith In Survival Of Breast Cancer, Franklin D. Lewis, Jr.

Walden Dissertations and Doctoral Studies

In 2013, approximately 232,340 women were diagnosed with breast cancer, and an estimated 39,620 women would die as a result of breast cancer. Stage I breast cancer can often be treated, but Stage IV breast cancer presents more difficulties in treatment, as it spreads to the bones, liver, or other areas of the body. Consequently, women with Stage IV breast cancer have very low 18 month and 5-year survival rates. According to some statistics, 79.5% of the United States population claim to be Christian. Much of this segment of the population uses faith to guide most aspects of their lives, …

Predicting Weight Management Advice Behavior Using Social Cognitive Theory Among Psychiatry Professionals, Chidi Chima

Walden Dissertations and Doctoral Studies

Obesity remains a public health concern among persons with mental illness resulting from the interaction of a combination of factors such as genetic, medication, effects of their symptoms, social, and environmental factors. Obesity complications account for increased mortality and morbidity, reduced life expectancy, and quality of life in persons with mental illness. The management of obesity is challenging and predicting the ability of mental health professionals to advise patients on weight management behavior is important to improve patients' overall well-being. The social cognitive theory constructs knowledge, expectations, situational perception, self-efficacy, and goal setting were utilized in predicting Weight Management Advice …