Epidemiology Commons^™

Hiv-Related Knowledge, Attitudes, And Behaviors In Two Low Resource Settings, Candice Lynn Collins

Electronic Theses and Dissertations

Two Human Immunodeficiency Virus (HIV) outbreaks occurred almost simultaneously in the United States (US) (2014-2015) and in Cambodia (2015). Information is lacking on HIV-related knowledge, stigmatizing attitudes, and high-risk behaviors (KAB) among the general population, which may affect the transmission of HIV and lead to outbreaks. The current study aimed to: 1) assess KAB among the general population in a high-risk county in the US, 2) analyze KAB among the general population of Cambodia, and 3) compare KAB across samples from a high-risk county in Northeast Tennessee and a province in Cambodia. Tennessee data were collected in 2017 and Cambodian …

The Incidence Rate, Types, And External Causes Of Traumatic Brain Injuries In Parkinson’S Disease Patients In Nebraska 2008-2014, Maher Alsaadi

Capstone Experience: Master of Public Health

Background: Parkinson’s disease (PD) patients are at higher risk of traumatic brain injury (TBI) due to disease characteristics like tremor, bradykinesia, and impaired balance. Most of the studies that have been done in the United States to investigate the incident rate and causes of TBI among PD patients have mainly focused on falls, while none of these studies have thoroughly addressed all causes of TBI among the PD population or have used a population-based database. Our study aims to investigate the incidence rate, types, and external causes of TBI stratified by age of PD diagnosis using a population-based database from …

Context, Delivery, And Providers’ Perspectives Of Family Life Education In Tn, Usa, Ruby Yadav

Electronic Theses and Dissertations

In 2015, TN had the 9^th highest teen birth rate in the United States. School-based sex education programs have shown promise in curbing teen pregnancy rates. In TN public schools, sex education could be taught by teachers of subjects like biology, health education, or invited guests from ministries, or national or local nonprofit agencies. The content, rigor, and approach of sex education taught by these diverse groups of providers remains unknown. This pilot study tested a survey questionnaire and methodology, while providing information on the providers’ sex education practices and perspectives.

We adapted validated measures from past sex education …

Metabolic And Inflammatory Biomarkers Are Associated With Epigenetic Aging Acceleration Estimates In The Goldn Study, Marguerite R. Irvin, Stella Aslibekyan, Anh Do, Degui Zhi, Bertha Hidalgo, Steven A. Claas, Vinodh Srinivasasainagendra, Steve Horvath, Hemant K. Tiwari, Devin M. Absher, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background: Recently, epigenetic age acceleration-or older epigenetic age in comparison to chronological age-has been robustly associated with mortality and various morbidities. However, accelerated epigenetic aging has not been widely investigated in relation to inflammatory or metabolic markers, including postprandial lipids.

Methods: We estimated measures of epigenetic age acceleration in 830 Caucasian participants from the Genetics Of Lipid Lowering Drugs and diet Network (GOLDN) considering two epigenetic age calculations based on differing sets of 5′-Cytosine-phosphate-guanine-3′ genomic site, derived from the Horvath and Hannum DNA methylation age calculators, respectively. GOLDN participants underwent a standardized high-fat meal challenge after fasting for at least …

Markers Of Cardiometabolic Risk And Thyroid Dysfunction In U.S. Adolescents: Nhanes Iii, Jonathan Austin

Theses and Dissertations

The global prevalence of metabolic syndrome (MetS) and its associated components (high fasting glucose, waist circumference, blood pressure, triglycerides, and low HDL) have increased over the past few decades. In addition, abnormal thyroid hormone levels have been found to manifest in a cascade of metabolic dysfunction, which may be linked to MetS in youth. PURPOSE: The purpose of the study is to investigate the association between MetS, its components, and markers of thyroid function in a nationally-representative sample of adolescents. METHODS: The National Health and Nutrition Examination Survey III (1988-1994) collected data on the components of metabolic syndrome and thyroid …

Adult Patients Living With Human Immunodeficiency Virus Hospitalized For Community-Acquired Pneumonia In The United States: Incidence And Outcomes, Leslie A. Beavin, Stephen P. Furmanek, Paula Peyrani, Anupama Raghuram, Forest W. Arnold, Mark Burns, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Community-acquired pneumonia (CAP) is a common infectious reason for hospitalization of adults in the United States (US), including those with Human Immunodeficiency Virus (HIV). While there are studies detailing the incidence and outcomes for all adults with CAP we are not aware of a recent study detailing incidence and outcomes in adult HIV patients hospitalized with CAP. The objectives of this study were (1) to define the current incidence and outcomes of adult HIV patients hospitalized with CAP in Louisville, Kentucky, and (2) to estimate the burden of CAP in the US HIV adult population.

Methods: This was a …

A Software Tool For Automated Upload Of Large Clinical Datasets Using Redcap And The Capo Database, William A. Mattingly, Christopher Sinclair, Danna Williams, Matthew Grassman, Stephen Furmanek, Kimberley Buckner, Mohammad Tahboub

The University of Louisville Journal of Respiratory Infections

Introduction: Obtaining clinical data from healthcare sources is necessary for conducting clinical research. New technologies now allow for connecting a research database to Electronic Medical Records remotely, allowing the automatic import of clinical research data. In this paper we design and evaluate a REDCap extension to import clinical records from an external health database.

Methods: Many hospital EHRs are designed to use secure file transfer protocol (SFTP) repositories for data communication. We develop a REDCap plugin to connect to an external SFTP file repository for the import of clinical record data. We use the CAPO instance of REDCap and a …

Bacteremic Pneumococcal Pneumonia: A Longitudinal Study In 279 Adult Patients From A Single Center, Jorge H. Gentile, Claudia Hernandez, Monica D. Sparo, Edgardo M. Rodriguez, Carolina Ceriani, Florencia Bruggesser

The University of Louisville Journal of Respiratory Infections

Background: Bacteremic pneumococcal pneumonia (BPP) is the most common clinical presentation of invasive pneumococcal disease (IPD). Although it has been extensively studied, there is little knowledge in our region in relation to burden of disease, demographic and outcome features.

Methods: We conducted a prospective, longitudinal, observational study from 1989 to 2015 in adult patients with BPP, in order to deepen our knowledge of the characteristics of this disease in our community hospital in Tandil, Argentina.

Results: 279 patients were included. The mean incidence was 2.8/1000 admissions with a sharp decrease in the last two years, reaching 0.8/1000 admissions. Mean patient …

An Hiv-Positive Patient With Copd Admitted To The Icu With Respiratory Failure, Bhavani Puskur, Veronica Corcino, Srikant Ramachandruni, Viswanathan Nagarajan, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Non-Resolving Community Acquired Pneumonia (Cap) Due To Blastomyces Dermatitidis (Pulmonary Blastomycosis): Case Report And Review Of Literature, Johnson Britto

The University of Louisville Journal of Respiratory Infections

In this case report, we describe a case of progressive acute pulmonary blastomycosis in a healthy adult living in Kentucky, initially presenting with flu like illness with a left sided consolidation, who did not respond to antibiotic therapy. Patient’s clinical condition deteriorated with development of necrotizing bronchopneumonia, mediastinal lymphadenopathy, tree-in-bud reticulonodularity and pleural effusion. A diagnosis of progressive pulmonary blastomycosis was established by radiological findings as well as transbronchial needle aspiration cytology and bronchoalveolar lavage culture demonstrating Blastomyces dermatitidis. Patient showed significant clinical improvement with resolution of pulmonary lesions on antifungal treatment. Since symptoms of blastomycosis are often similar to …

Effectiveness Of The Influenza Vaccine In Preventing Hospitalizations Of Patients With Influenza Community-Acquired Pneumonia, Thomas Chandler, Stephen P. Furmanek, Connor L. English, Connor Glick, Wesley Trail, Lara Daniels, Ugochukwu Owolabi, Ruth Carrico, Julio A. Ramirez, Timothy L. Wiemken

The University of Louisville Journal of Respiratory Infections

Introduction: Influenza vaccination is the primary strategy for prevention of influenza infection. Influenza infection can vary from mild or even asymptomatic illness to severe community-acquired pneumonia (CAP). Although many national and international investigators and organizations report annual estimates of influenza vaccine effectiveness for prevention of influenza infection in the community, few studies report estimates for the prevention of hospitalizations due to influenza CAP, the most severe form of the infection. The objective of this study is to determine the effectiveness of the influenza vaccine for prevention of hospitalization in patients with influenza-associated CAP.

Methods: This was a test-negative study using …

Duration Of Antibiotic Therapy For Patients With Bacteremic Staphylococcus Aureus Community-Acquired Pneumonia, Julio A. Ramirez, Thomas File, Daniel Musher

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Real-Time Pcr Detection Of Mycoplasma Pneumoniae, Chlamydia Pneumoniae And Legionella Pneumophila In Respiratory Specimens Using The Aries® System, Subathra Marimuthu, Leslie A. Wolf, James T. Summersgill

The University of Louisville Journal of Respiratory Infections

Background: Mycoplasma pneumoniae (Mpn), Chlamydia pneumoniae (Cpn), and Legionella pneumophila (Lpn) can cause both epidemic and endemic occurrences of acute respiratory disease and are responsible for up to 22% of cases of community acquired pneumonia. Due to the limited availability of FDA-approved molecular diagnostic assays, we developed and evaluated a multiplexed Real-time PCR assay for the detection of these agents in two respiratory specimen types on the Luminex ARIES® instrument. The instrument provides for nucleic acid extraction plus PCR amplification and target detection in the same cassette. The ARIES® instrument generates a cycle threshold value and a confirmatory melt curve …

Communication Between Clinicians And The Hospital-Based Microbiology Laboratory: Strategies For 2018 And Beyond, Hans H. Liu

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Mycobacterium Kansasii As The Primary Etiology Of Pulmonary Infections Due To Non-Tuberculous Mycobacterium (Ntm) In Patients Without Human Immunodeficiency Virus (Hiv): Experience From A Center In Buenos Aires, Argentina, Gabriel Yusti, Marcela Heres, Alejandra González, Mariano Fielli, Adrian Ceccato, Alejandra Zapata

The University of Louisville Journal of Respiratory Infections

Introduction: Pulmonary diseases due to non-tuberculous mycobacterium (NTM) lung infection in HIV-negative patients are rarely described in the literature. Currently, NTM consist of more than 150 species, and they are globally ubiquitous in both natural and man-made environments.The objective of this study was to define the most frequent species of NTM causing pulmonary disease in HIV-negative patients in the city of Buenos Aires, Argentina. The prevalence of pulmonary diseases caused by NTM is difficult to determine since the isolation of NTM does not necessarily indicate disease.

Methods: A retrospective review of all the respiratory cultures positive for NTM in the …

Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, The Clinical Research Coordinating Center Team

The University of Louisville Journal of Respiratory Infections

Insufficient infrastructure is one of the challenges facing investigators in the field of clinical research. At the University of Louisville (UofL) Division of Infectious Diseases, we developed a multidisciplinary coordinating center with the aim to support investigators in all aspects of the clinical research process. The objective of this article is to describe the composition and the role of the different units of the UofL Clinical Research Coordinating Center. The different components of the Center can serve as a template for institutions interested in developing a clinical research support infrastructure.

Clinical Research: From Idea To Publication, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Julio A. Ramirez, M.D., FACP, Professor of Medicine/Associate Professor of Microbiology and Immunology; Chief, Division of Infectious Diseases; Director, Infectious Diseases Fellowship Training Program and Founding Director, Global Health Initiative at The University of Louisville, presented "Clinical Research: From Idea to Publication" at University of Louisville Department of Medicine Grand Rounds on February 15, 2018. The talk focused on performing an overview of clinical study designs, describing the planning and performing of a clinical study, reviewing the process for statistical and clinical analysis, and presenting the structure of a Clinical Research Coordinating Center.

Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, Andrea Reyes-Vega

Faculty and Staff Scholarship

Insufficient infrastructure is one of the challenges facing investigators in the field of clinical research. At the University of Louisville (UofL) Division of Infectious Diseases, we developed a multidisciplinary coordinating center with the aim to support investigators in all aspects of the clinical research process. The objective of this article is to describe the composition and the role of the different units of the UofL Clinical Research Coordinating Center. The different components of the Center can serve as a template for institutions interested in developing a clinical research support infrastructure.

Amphibians And Reptiles As A Source Of Salmonella – A Review Of Salmonella Outbreaks In A Period Of Last Ten Years, Mateusz Drozdz, Gabriela Bugla-Plooskonska

Appalachian Student Research Forum

Salmonellosis is a serious problem of public health that mainly infants, young children and people with immunodeficiencies face. Human direct contact with animals is one of the possible ways of transmission of the disease. An increasing trend of keeping exotic pets, including amphibians and reptiles, has been observed for recent years in the United States and developing European countries. Most of these animals are asymptomatic carriers of Salmonella. However, in this review we introduced new and the most dangerous outbreaks of salmonellosis caused by contact with amphibians and reptiles that appeared in all continents in last ten years.

It was …

Recent Incidences And Trends Of The Top Five Cancers In Northeast Appalachian Tennessee, Adekunle Oke, Sylvester Olubolu Orimaye, Ndukwe Kalu, Faustine Williams

Appalachian Student Research Forum

Introduction: Cancer is the second leading cause of death in the United States (U.S.), after cardiovascular disease. Although there has been a continuous decline in cancer mortality rates in the U.S. over the past two decades, the Appalachian region, which extends through 13 states and 420 counties in the southeastern part of the U.S., has seen a lower decline in cancer mortality. From 1980-2014, cancer deaths decreased by almost 45%, but cancer mortality rates in rural Appalachia was 36% higher than for urban non-Appalachian counties. In terms of cancer-specific, although breast cancer mortality rates have also decreased significantly nationally, a …

The Distribution Of Hepatitis C Virus Genotypes In Us Population. Data From Nhanes 2006-2016, Hilary Elom, Shimin Zheng

Appalachian Student Research Forum

Background: Unlike other non-hepatitis c viral infection, hepatitis c viral infection is a non-vaccine preventable disease. Thus, effective treatment is an important part in the prevention of complication of chronic hepatitis c infection. The viral genotype plays a significant role in the choice of treatment regimen.

Aim: the purpose of this study is to estimate the prevalence of hepatitis c viral infection and the distribution of viral genotype in the US population.

Methods: Diagnosis of Hepatitis C viral infection was made by assaying the blood specimen collected from the study participants using Ampiclor monitor (Roche Diagnostic System, Inc Branchburg …

Impact Of Adverse Childhood Experiences On Hiv Risk Behaviors Using A Nationally Representative Sample From 2011 And 2012, Elaine Loudermilk, Megan Quinn, Liang Wang

Appalachian Student Research Forum

Introduction: Adverse childhood experiences (ACEs) have been linked with negative physical and mental health outcomes in adulthood. A limited amount of literature has discussed the impact of individual ACEs on HIV risk behaviors using nationally representative data.

Objective: This study investigated how ACEs impact HIV risk behaviors using cross-sectional data from the 2011 and 2012 Behavioral Risk Factor Surveillance System (BRFSS).

Methods: Data were obtained from BRFSS for 2011 and 2012. Only states that answered the optional ACE questionnaire were included in the study. All ten ACEs were categorized into abuse (parents physically hurt you in any way or parents …

Association Between Smoking And Functional Outcome In Acute Ischemic Stroke Population Treated With Tissue Plasminogen Activator, Iretioluwa Ajani, Oluyemi R. Rotimi, Olubunmi Kuku, Ndukwe Kalu, Olakunle Oni, Christian Nwabueze, Thomas Nathaniel, Shimin Zheng

Appalachian Student Research Forum

Association between Smoking and Functional Outcome in Acute Ischemic Stroke Population Treated with Tissue Plasminogen Activator

Iretioluwa Ajani¹, Oluyemi Rotimi¹, Olubunmi Kuku¹, Ndukwe Kalu¹, Olakunle Oni¹, Nwabueze Christian¹,Thomas Nathaniel², Shimin Zheng^1*

¹Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614

²Department of Neurology, Department of Pharmacology, Physiology & Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208

*Sponsoring faculty

Background

The effect of smoking on outcome in acute ischemic stroke patients treated with …

Factors That Affect Early Sexual Initiation In A Sample Of College Students In North-East Tennessee: The Role Of Adverse Childhood Experiences, Economic Hardship, Family Structure And Religiosity., Oluyemi R. Rotimi, Hima Bindu Dubasi, Ruby Yadav, Mildred Maisonet

Appalachian Student Research Forum

Background

Normal adolescent development often involves sexual activity. Early sexual initiation poses a challenge to health and well-being. In 2015, Tennessee had the 9^th highest teen birth rate in the country. The structural, social and economic environments of growth define sexual risk taking, with poverty, Adverse Childhood Experiences (ACEs) religiosity and family structure known to affect adolescent and adult health. This study seeks to explore the effect of these factors on early sexual initiation.

Methods

A sample of college students taking the introductory psychology course participated in the study through the ETSU SONA system. They completed a self-reported web-based …

Hiv Clustering In Mississippi: Spatial Epidemiological Study To Inform Implementation Science In The Deep South, Thomas J. Stopka, Lauren Brinkley-Rubinstein, Kendra Johnson, Philip A. Chan, Marga Hutcheson, Richard A. Crosby, Deirdre Burke, Leandro Mena, Amy Nunn

Health, Behavior & Society Faculty Publications

Background: In recent years, more than half of new HIV infections in the United States occur among African Americans in the Southeastern United States. Spatial epidemiological analyses can inform public health responses in the Deep South by identifying HIV hotspots and community-level factors associated with clustering.

Objective: The goal of this study was to identify and characterize HIV clusters in Mississippi through analysis of state-level HIV surveillance data.

Methods: We used a combination of spatial epidemiology and statistical modeling to identify and characterize HIV hotspots in Mississippi census tracts (n=658) from 2008 to 2014. We conducted spatial analyses of all …

Vaccine Epidemiology And Decision-Making: A Bryant Student Focus, Hannah Coburn

Honors Projects in Science and Technology

The Centers for Disease Control and Prevention estimate that influenza has resulted in between 9.2 and 35.6 million illnesses and between 12,000 and 56,000 deaths annually since 2010 (1). Annual influenza vaccination remains to be the most effective way in controlling the spread and symptom severity of influenza infections (1). Influenza infections are especially virulent on college campuses as a dense population of students interact in close quarters such as shared housing, bathrooms, dining halls, classrooms, and social activities (2). Despite influenza vaccinations being safe, effective, easily accessible to Bryant University students, and free of cost, many students choose not …

Cross-Sectional Comparison Of Behavioral Risk Factors For Hiv/Hcv In People Who Inject Drugs (Pwid) In Egypt, Sarah Martinez, Amira A. Roess, Monica S. Ruiz, Atef Bakhoum, Ehab El Kharrat

GW Research Days 2016 - 2020

Background

Egypt has the greatest HCV prevalence worldwide at 15% and a concentrated HIV epidemic in male people who inject drugs (PWID) at 6.8%, who are at a high risk for HCV infection as well. Injection drug use is criminalized in Egypt, and there is limited availability of harm reduction programs. Drug-use and sexual risk behaviors between PWID and the general population have not been studied there.

Methods

To address this gap, a cross-sectional HIV/HCV epidemiological study of 632 consenting injection drug users in Cairo and Alexandria was conducted. Bivariate logistic regression analysis was done to evaluate the associations between …

Physical Activity Across The Lifespan And Liver Cancer Incidence In The Nih-Aarp Diet And Health Study Cohort., Hannah Arem, Erikka Loftfield, Pedro F Saint-Maurice, Neal D Freedman, Charles E Matthews

Epidemiology Faculty Publications

While liver cancer rates in the United States are increasing, 5-year survival is only 17.6%, underscoring the importance of prevention. Physical activity has been associated with lower risk of developing liver cancer, but most studies assess physical activity only at a single point in time, often in midlife. We utilized physical activity data from 296,661 men and women in the NIH-AARP Diet and Health Study cohort to test whether physical activity patterns over the life course could elucidate the importance of timing of physical activity on liver cancer risk. We used group modeling of longitudinal data to create physical activity …

Rural And Urban Injection Drug Use In Puerto Rico: Network Implications For Human Immunodeficiency Virus And Hepatitis C Virus Infection, Courtney Thrash, Melissa L. Welch-Lazoritz, G. Robin Gauthier, Bilal Khan, Roberto Abadie, Kirk Dombrowski, Sandra Miranda De Leon, Yadira Rolon Colon

Department of Sociology: Faculty Publications

Understanding the short- and long-term transmission dynamics of blood-borne illnesses in network contexts represents an important public health priority for people who inject drugs and the general population that surrounds them. The purpose of this article is to compare the risk networks of urban and rural people who inject drugs in Puerto Rico. In the current study, network characteristics are drawn from the sampling “trees” used to recruit participants to the study. We found that injection frequency is the only factor significantly related to clustering behavior among both urban and rural people who inject drugs.

Epidemiology News, Georgia Southern University

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

• Georgia Southern Collaborates on Community-Engaged Energy Balance Interventions