Epidemiology Commons^™

Hiv Vaccine Acceptability Among High-Risk Drug Users In Appalachia: A Cross-Sectional Study, April M. Young, Ralph J. Diclemente, Daniel S. Halgin, Claire E. Sterk, Jennifer R. Havens

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: A vaccine could substantially impact the HIV epidemic, but inadequate uptake is a serious concern. Unfortunately, people who use drugs, particularly those residing in rural communities, have been underrepresented in previous research on HIV vaccine acceptability. This study examined HIV vaccine acceptability among high-risk drug users in a rural community in the United States.

METHODS: Interviewer-administered questionnaires included questions about risk behavior and attitudes toward HIV vaccination from 433 HIV-negative drug users (76% with history of injection) enrolled in a cohort study in Central Appalachia. HIV vaccine acceptability was measured on a 4-point Likert scale. Generalized linear mixed models …

"Nursing Contamination: Wearing Scrubs In Public", Kemble Green

Undergraduate Honors Theses

Nurses are frequently seen in public in their “scrubs,” which could mean that contaminated clothing is being brought into the community, thereby posing an infection risk. The purpose of this study is to investigate if and which contaminants are present on the fabrics and the actions nurses are taking to eliminate contamination risks.

Eleven scrub tops were worn on hospital units over one twelve-hour shift. The contaminated scrubs and three control tops were then swabbed and used to inoculate agar plates. After incubation, colonies were counted, streaked onto nutrient and Mannitol-salt agar for isolation, and incubated. Using API Staph strips …

Markers And Mechanisms Of Metabolic Aging., Peter Dziewornu Ahiawodzi

Electronic Theses and Dissertations

Oxidative stress has been implicated in aging and age-related diseases. Using three distinct studies, this dissertation examines associations between lifestyle factors and oxidative stress, and their effects on advanced glycation end products, telomere length, and type II diabetes. Carboxymethyl-lysine (CML), an advanced glycation end-product, has been linked to oxidative stress, cardiovascular and other age-related diseases. The first study investigates the association between sleep disordered breathing (SDB), a source of oxidative stress, and CML. 1002 participants with sleep data from the Cardiovascular Health Study (CHS) were analyzed. SDB was not significantly associated with CML, but after stratification by gender and hemoglobin …

The Performance Of The K6 Scale In A Large Adolescent Sample., Nicholas Chalmer Peiper 1982-

Electronic Theses and Dissertations

This dissertation is an applied research study to examine the performance of the K6 scale that measures serious emotional disturbance (SED) among adolescents. As the K6 was included in the 2012 administration of the Kentucky Incentives for Prevention Survey (KIP), three specific aims are included: 1) confirm the unidimensional structure of the K6 among adolescents using factor analysis; 2) define the prevalence and correlates of adolescent SED among Kentucky students; and 3) utilize latent class analysis (LCA) to empirically derive clinically relevant subtypes of adolescents with SED. Of the 122,718 students who completed the KIP in 2012, approximately 89% provided …

Effectiveness Of Chronic Obstructive Pulmonary Disease (Copd) Management Program At The University Of Louisville., Malhar Anantbhai Jhaveri

Electronic Theses and Dissertations

Background: Chronic obstructive pulmonary disease (COPD) is a progressive disease of the respiratory system characterized by airflow limitation that is not completely reversible and is associated with systemic effects especially of the cardiovascular system. COPD is frequently complicated by acute exacerbations that contribute to physical impairment and increased health care use. As COPD is a chronic lung disease with significant systemic manifestations, it is important to have chronic disease management programs specifically targeting individuals with COPD designed to improve their overall quality of life, reduce the burden of disease and decrease the impact of COPD on daily life. Chronic disease …

Prevalence And Risk Factors For Active Convulsive Epilepsy In Rural Northeast South Africa, Ryan G. Wagner, Anthony Ngugi, Rhian Twine, Christian Bottomley, Gathoni Kamuyu, F Xavier Gómez-Olivé, Myles D. Connor, Mark A. Collinson, Kathleen Kahn, Stephen Tollman, Charles R. Newton

Family Medicine, East Africa

Rationale: Epilepsy is among the most common neurological disorders worldwide. However,there are few large, population-based studies of the prevalence and risk factors for epilepsy in southern Africa.

Methods: From August 2008 to February 2009, as part of a multi-site study, we undertook a three-stage, population-based study, embedded within the Agincourt health and socio-demographic surveillance system, to estimate the prevalence and identify risk factors of active convulsiveepilepsy (ACE) in a rural South African population.

Results: The crude prevalence of ACE, after adjusting for non-response and the sensitivity of the screening method, was 7.0/1,000 individuals (95%CI 6.4—7.6) with significant geographic hetero-geneity across …

Validity And Reliability Testing Of The National Health And Nutrition Examination Survey (Nhanes) Taste And Smell Protocol, Mallory Honda

Honors Scholar Theses

The NHANES 2011–2014 protocol includes a taste and smell questionnaire (CSQ) in the home interview followed by brief olfactory and taste assessment in mobile exam centers. The CSQ asks self-reported taste and smell ability, and selected symptoms, comorbidities, and treatment for chemosensory disorders. In the taste assessment, participants rate intensities of 1 M NaCl and 1mM quinine hydrochloride applied to the tongue tip and these plus 0.32M NaCl sampled with the whole mouth. Smell function is assessed with two 4-item, scratch-and-sniff tests (Pocket Tests^TM (PT), Sensonics, Inc.) to classify normosmia and olfactory dysfunction from microsmia to anosmia. We examined …

Coal Ash And Children's Sleep : A Community-Based Study., Clara G. Sears

Electronic Theses and Dissertations

Kentucky is the fifth largest producer of coal ash, a by-product of coal combustion. The small spherical coal ash particles contain heavy metals like arsenic, lead, mercury, and cadmium. Coal ash is currently classified as nonhazardous by the EPA, which allows it to be stored in open-air impoundments near low-income communities. The primary object of the study is to determine the prevalence of sleep disruptive behaviors in children exposed to coal ash, compared to a group of demographically similar non-exposed children. Parents or guardians from five neighborhoods surrounding a coal ash storage facility, and one non-exposed community, participated in a …

A Survey Of Antimicrobial Stewardship Practices In The Western United States: Successes And Challenges, Gayle Louise Allenback

UNLV Theses, Dissertations, Professional Papers, and Capstones

Antibiotics are one of the most important developments in medicine, and their ability to prevent and control infections has had a major impact in clinical medicine. However, the past three decades have shown an increase in multidrug-resistant organisms (MDROs) in both hospital patients and in the community, decreasing our ability to successfully control infection. Complicating the depletion of effective antimicrobials is the fact that, in the last 10 years, there has also been a decrease in the development of new antibacterial agents. Resistant infections have resulted in increased morbidity and mortality, with a consequential increase in healthcare costs. The utilization …

Determinants Of Head And Neck Cancer Survival In Nevada For 1995-2008, Xiao Q. Li

UNLV Theses, Dissertations, Professional Papers, and Capstones

Head and neck cancer (HNC), also known as oral cavity and pharyngeal cancer, comprises a group of cancers that arise in the head or neck region, such as the nasal cavity, sinuses, lips, mouth, salivary glands, and pharynx. Use of tobacco, alcohol, or a combination of the two, are major risk factors for head and neck cancer. Approximately 75% of oral cancers are attributable to smoking and/or alcohol consumption. More recently, the human papilloma virus (HPV) has also been associated with the development of head and neck cancer.

The objective of the present study is to investigate head and neck …

University Students And The Risk Of Hiv And Other Sexually Transmitted Infections In Uganda: The Crane Survey., George W. Rutherford, Andrew Anglemyer, Danstan Bagenda, Michael Muyonga, Christina P. Lindan, Joseph L. Barker, Lisa Johnston, Wolfgang Hladik

Journal Articles: Epidemiology

Adolescents and young adults are at high risk of human immunodeficiency virus (HIV) infection in sub-Saharan Africa. Previous reports have found that university students in Africa comprise a sexually active population, although the prevalence of HIV or sexually transmitted infections (STI) has not been measured. We conducted a cross-sectional survey of students from five large universities in Kampala, Uganda, using respondent-driven sampling. We asked students to complete behavioral questionnaires and provide biological samples to test for HIV, Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Trichomonas vaginalis, and bacterial vaginosis. We enrolled 649 students and obtained interpretable data from 640. Around 50% …

Cognitive Decline And Polypharmacy In An Elderly Population., Ximena A. Oyarzun Gonzalez

Electronic Theses and Dissertations

Aging is associated with increased risk of chronic disease, comorbidities, and greater medication use. Polypharmacy, the concomitant use of 5 or more medications, has been associated with adverse health effects, and potentially cognitive decline. The proposed hypothesis is that polypharmacy increases the risk of cognitive decline in elderly people. Using longitudinal data from 572 participants from the New Mexico Aging Process Study cohort, the impact of polypharmacy on the Mini Mental State Examination (MMSE) scores and Mild Cognitive Impairment (MCI) was studied. The statistical analyses were performed using mixed linear regression multivariable models and generalized estimating equations, adjusting for important …

Assessing The Impact Of Misclassification When Comparing Prevalence Data: A Novel Sensitivity Analysis Approach, Ninet Sinaii, Sean D. Cleary, Pamela Stratton

Epidemiology Faculty Publications

Background: A simple sensitivity analysis technique was developed to assess the impact of misclassification and verify observed prevalence differences between distinct populations.

Methods: The prevalence of self-reported comorbid diseases in 4,331 women with surgically-diagnosed endometriosis was compared to published clinical and population-based prevalence estimates. Disease prevalence misclassification was assessed by assuming over-reporting in the study sample and under-reporting in the general (comparison) population. Over- and under-reporting by 10%, 25%, 50%, 75%, and 90% was used to create a 5×5 table for each disease. The new prevalences represented by each table cell were compared by p-values, prevalence odds ratios, and 95% …

Performance Of The Oraquick Hcv Rapid Antibody Test For Screening Exposed Patients In A Hepatitis C Outbreak Investigation, Fengxiang Gao, Elizabeth A. Talbot, Carol H. Loring, Jill J. Power, Jodie Dionne-Odom

Dartmouth Scholarship

During a nosocomial hepatitis C outbreak, emergency public clinics employed the OraQuick HCV rapid antibody test on site, and all results were verified by a standard enzyme immunoassay (EIA). Of 1,157 persons, 1,149 (99.3%) exhibited concordant results between the two tests (16 positive, 1,133 negative). The sensitivity, specificity, positive predictive value, and negative predictive value were 94.1%, 99.5%, 72.7%, and 99.9%, respectively. OraQuick performed well as a screening test during an outbreak investigation and could be integrated into future hepatitis C virus (HCV) outbreak testing algorithms.

Drug Use And Social Support Outcomes In Probationers: A Longitudinal Social Network Analysis, Anne Rhodes

Theses and Dissertations

This study focuses on the social networks of probationers, who comprise the largest segment of the criminal justice population in the United States, but about whom there are few studies of network processes. It provides information on how elements of a probationer’s social network change over time and can affect drug use. This study employs longitudinal analysis of the social networks for 251 substance abusers on probation to examine how these networks are influenced by an intervention designed to increase pro-social behaviors and how network changes impact drug use. Baseline drug use of the probationers was examined according to the …

Federal Disaster Declarations And Denials: Analyzing Spatial Equity In The Implementation Of The Stafford Act, Richard Salkowe

USF Tampa Graduate Theses and Dissertations

Federal disaster declarations are authorized by the president under the provisions of the Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1988. Prior studies have found varying levels of political influence associated with the declaration process. Factors including electoral votes, reelection years, congressional committee appointments, geographic location, and party favoritism have been implicated in claims of inequity associated with the distribution of federal disaster assistance. Compounding these concerns is evidence of recurring problems associated with disparities in the long-term recovery from disasters based on social and economic factors. This dissertation is a response to the call for further …

Historical Health Conditions In Major Us Cities: The Hue Data Set, Carlos Villareal, Brian Bettenhausen, Eric Hanss, Jonathan Hersh

Economics Faculty Articles and Research

The Historical Urban Ecological data set is a new resource detailing health and environmental conditions within seven major U.S. cities during the study period from 1830 to 1930. Researchers collected and digitized ward-level data from annual reports of municipal departments that detail the epidemiological, economic, and demographic conditions within each city. They then drafted new geographic information system data to link the tabular records to ward geographies. These data provide a new foundation to revisit questions surrounding the urban mortality transition and the growth of U.S. cities.

Frailty And Depression: A Latent Trait Analysis, Matthew Lohman

Theses and Dissertations

Background: Frailty, a state indicating vulnerability to poor health outcomes, is a common condition in later life. However, research and intervention progress is hindered by the current lack of a consensus frailty definition and poor understanding of relationships between frailty and depression. Objectives: The goal of this research is to understand the interrelationships between frailty and depression among older adults. Specifically, this project aims 1) to examine the construct overlap between depression and three definitions of frailty (biological syndrome, medical burdens, and functional domains), 2) to determine the degree to which this overlap varies by age, gender, race/ethnicity and other …

Socioeconomic And Demographic Factors Modify The Association Between Informal Caregiving And Health In The Sandwich Generation, Elizabeth K. Do, Steven A. Cohen, Monique J. Brown Ph.D., Mph

Faculty Publications

Background

Nearly 50 million Americans provide informal care to an older relative or friend. Many are members of the “sandwich generation”, providing care for elderly parents and children simultaneously. Although evidence suggests that the negative health consequences of caregiving are more severe for sandwiched caregivers, little is known about how these associations vary by sociodemographic factors.

Methods

We abstracted data from the Behavioral Risk Factor Surveillance System to determine how the association between caregiving and health varies by sociodemographic factors, using ordinal logistic regression with interaction terms and stratification by number of children, income, and race/ethnicity.

Results

The association between …

Assessing The Impact Of Family Status, Family Cohesion, And Acculturation On Youth Violence Among Immigrant Latinos, Susan Lin, Sean D. Cleary, Mark Edberg

GW Research Days 2014

Background/Objectives: Latino youth violence is an emerging public health concern. The objective is to assess the impact of family status, family cohesion, and acculturation on youth violence among Latino immigrants in Langley Park, MD compared with a control community in Culmore, VA.

Methods: Constructs were generated from survey questions to represent family support and cohesion, acculturation, and youth violence. Bivariate and multivariate regression analyses were modeled to evaluate the relationships between family support and cohesion, acculturation, and violence, after adjusting for confounders.

Results: After controlling for covariates, family support consistently reduced victimization (PE = ‐0.02, SE = 0.01, t = …

Venue-Based Recruitment Of Women At Elevated Risk For Hiv: An Hiv Prevention Trials Network Study, Danielle F. Haley, Carol E. Golin, Wafaa M. El-Sadr, James P. Hughes, Jing Wang, Irene Kuo, +13 Additional Authors

Epidemiology Faculty Publications

Background: The challenge of identifying and recruiting U.S. women at elevated risk for HIV acquisition impedes prevention studies and services. HIV Prevention Trials Network (HPTN) 064 was a U.S. multisite, longitudinal cohort study designed to estimate HIV incidence among women living in communities with prevalent HIV and poverty. Venue-based sampling (VBS) methodologies and participant and venue characteristics are described.

Methods: Eligible women were recruited from 10 U.S. communities with prevalent HIV and poverty using VBS. Participant eligibility criteria included age 18–44 years, residing in a designated census tract/zip code, and self-report of at least one high-risk personal and/or male sexual …

The Impact Of Salsalate Treatment On Serum Levels Of Advanced Glycation End Products In Type 2 Diabetes., Joshua I Barzilay, Kathleen A. Jablonski, Vivian Fonseca, Steven E Shoelson, Allison B Goldfine, Christopher Strauch, Vincent M Monnier, Tinsal-T2d Research Consortium.

GW Biostatistics Center

OBJECTIVE Salsalate is a nonacetylated salicylate that lowers glucose levels in people with type 2 diabetes (T2D). Here we examined whether salsalate also lowered serum-protein-bound levels of early and advanced glycation end products (AGEs) that have been implicated in diabetic vascular complications. RESEARCH DESIGN AND METHODS Participants were from the Targeting Inflammation Using Salsalate for Type 2 Diabetes (TINSAL-T2D) study, which examined the impact of salsalate treatment on hemoglobin A1c (HbA1c) and a wide variety of other parameters. One hundred eighteen participants received salsalate, 3.5 g/day for 48 weeks, and 109 received placebo. Early glycation product levels (HbA1c and fructoselysine …

Genetic Risk Of Progression To Type 2 Diabetes And Response To Intensive Lifestyle Or Metformin In Prediabetic Women With And Without A History Of Gestational Diabetes Mellitus., Shannon D Sullivan, Kathleen A. Jablonski, Jose C Florez, Dana Dabelea, Paul W Franks, Sam Dagogo-Jack, Catherine Kim, William C Knowler, Costas A Christophi, Robert Ratner, Diabetes Prevention Program Research Group.

GW Biostatistics Center

OBJECTIVE The Diabetes Prevention Program (DPP) trial investigated rates of progression to diabetes among adults with prediabetes randomized to treatment with placebo, metformin, or intensive lifestyle intervention. Among women in the DPP, diabetes risk reduction with metformin was greater in women with prior gestational diabetes mellitus (GDM) compared with women without GDM but with one or more previous live births.

RESEARCH DESIGN AND METHODS We asked if genetic variability could account for these differences by comparing β-cell function and genetic risk scores (GRS), calculated from 34 diabetes-associated loci, between women with and without histories of GDM.

RESULTS β-Cell function was …

Metabolic Syndrome Components And Their Response To Lifestyle And Metformin Interventions Are Associated With Differences In Diabetes Risk In Persons With Impaired Glucose Tolerance, H. Florez, M. Temprosa, Trevor J. Orchard, Kieren J. Mather, Santica M. Marcovina, Elizabeth Barrett-Connor, Edward Horton, C. D. Saudek, F. X. Pi-Sunyer, R. E. Ratner, R. B. Goldberg

GW Biostatistics Center

Aims

To determine the association of metabolic syndrome (MetS) and its components with diabetes risk in participants with impaired glucose tolerance (IGT), and whether intervention-related changes in MetS lead to differences in diabetes incidence.

Methods

We used the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) revised MetS definition at baseline and intervention-related changes of its components to predict incident diabetes using Cox models in 3234 Diabetes Prevention Program (DPP) participants with IGT over an average follow-up of 3.2 years.

Results

In an intention-to-treat analysis, the demographic-adjusted hazard ratios (95% confidence interval) for diabetes in those with MetS (vs. …

Forecasting The Spread Of Raccoon Rabies Using A Purpose-Specific Group Decision-Making Process., Aaron M. Anderson, Stephanie A. Shwiff, Richard B. Chipman, Todd C. Atwood, Tyler Cozzens, Frank Fillo, Robert Hale, Brody Hatch, Joanne Maki, Olin E. Rhodes Jr., Erin E. Rees, Charles E. Rupprecht, Rowland Tinline, Kurt C. Vercauteren, Dennis Slate

United States Department of Agriculture Wildlife Services: Staff Publications

The Centers for Disease Control (CDC) and USDA Wildlife Services (WS) have been involved in an oral rabies vaccination (ORV) program for raccoons (Procyon lotor) that has slowed the westward spread of raccoon rabies. The objective of this study was to forecast the spread of the disease if an ORV zone was not maintained. A group decision-making process was designed to address the forecasting problem and was implemented using a group of 15 experts and 4 support personnel at a meeting at the USDA National Wildlife Research Center. Ten expansion regions were constructed that described the spread of …

Epidemiology News, Georgia Southern University

Biostatistics, Epidemiology & Environmental Health Sciences: News & Publications (2011-2018)

• HPV Vaccine

Heterogeneity, Not Randomness, Sets Challenges For Quantitative Genetics And Epidemiology: A Response To Davey Smith’S “Gloomy Prospect”, Peter J. Taylor

Working Papers on Science in a Changing World

Social epidemiologist Davey Smith (2011) argues that epidemiologists should accept a gloomy prospect: considerable randomness at the individual level means that they should keep their focus on modifiable causes of disease at the population level. The difficulty epidemiology has had in moving from significant population-level risk factors to improved prediction of cases at an individual level is analogous to the lack of success in the search for systematic aspects of the non-shared environmental influences that human quantitative genetics claims overshadow common environmental influences (e.g., the family’s socioeconomic status which siblings have in common). This article responds to the argument and …

Elective Early Term Delivery And Adverse Infant Outcomes In A Population-Based Multiethnic Cohort, Jason Lee Salemi

USF Tampa Graduate Theses and Dissertations

The length of human pregnancy, arguably the most natural of physiological processes, is undergoing subtle but consequential modification in order to adapt to modern societal demands. The gestational age distribution of births in the United States has been shifting to lower gestational ages over the past two decades, parallel to a concomitant rise in obstetrical intervention in pregnancy. The result has been an increase in elective deliveries at 37-38 weeks (early term).

A population-based retrospective cohort study of over 616,000 live-born full-term singleton infants was conducted to investigate the association between elective early term delivery and subsequent infant morbidity, mortality, …

Epidemiology News, Georgia Southern University

Biostatistics, Epidemiology & Environmental Health Sciences: News & Publications (2011-2018)

• Diabetes and Colorectal Cancer Screening

A Unification Of Mediation And Interaction: A Four-Way Decomposition, Tyler J. Vanderweele

Harvard University Biostatistics Working Paper Series

It is shown that the overall effect of an exposure on an outcome, in the presence of a mediator with which the exposure may interact, can be decomposed into four components: (i) the effect of the exposure in the absence of the mediator, (ii) the interactive effect when the mediator is left to what it would be in the absence of exposure, (iii) a mediated interaction, and (iv) a pure mediated effect. These four components, respectively, correspond to the portion of the effect that is due to neither mediation nor interaction, to just interaction (but not mediation), to both mediation …