Epidemiology Commons^™

Air Pollution & Asthma Prevalence: Hotspot Analysis On Environmental Injustice In Buffalo, New York, Zuveria Shaguphta

Graduate Dissertations and Theses

This research aims to focus on the historical impacts of segregation in these communities (with Census Bureau data) and whether we see that these are the areas with continued segregation and a disproportionate number of TRI facilities. The third part of this research will be to investigate the presence of asthma in these neighborhoods as documented by the New York State Health Department. Asthma is a chronic disease in which the airways are inflamed due to some kind of external factor causing this reaction. Literature shows that there is a relationship between outdoor air pollution from combustion of fossil fuels …

Post-Acquisition Processing Confounds In Brain Volumetric Quantification Of White Matter Hyperintensities, Ahmed A. Bahrani, Omar M. Al-Janabi, Erin L. Abner, Shoshana H. Bardach, Richard J. Kryscio, Donna M. Wilcock, Charles D. Smith, Gregory A. Jicha

Neurology Faculty Publications

BACKGROUND: Disparate research sites using identical or near-identical magnetic resonance imaging (MRI) acquisition techniques often produce results that demonstrate significant variability regarding volumetric quantification of white matter hyperintensities (WMH) in the aging population. The sources of such variability have not previously been fully explored.

NEW METHOD: 3D FLAIR sequences from a group of randomly selected aged subjects were analyzed to identify sources-of-variability in post-acquisition processing that can be problematic when comparing WMH volumetric data across disparate sites. The methods developed focused on standardizing post-acquisition protocol processing methods to develop a protocol with less than 0.5% inter-rater variance.

RESULTS: A series …

Exploring The Hispanic Health Paradox In Mental Health Outcomes: Evidence From The Us-Mexico Border, Laryssa Mykyta, Suad Ghaddar, Leonel Vela

Health & Biomedical Sciences Faculty Publications and Presentations

Background: Research has established that Hispanic immigrants experience better health outcomes than their US-born counterparts. However, it is unclear whether the immigrant advantage holds for mental health. The purpose of this study is to examine mental health disparities by nativity status in an underserved Hispanic population along the southern border.

Methods: We collected data (N=713, weighted 733,644 adults) in four counties (90% Hispanic) along the Texas-Mexico border from March through August 2018 utilizing a dual-frame sampling design (random-digit dial telephone survey and field survey in randomly-selected colonias). We assessed several mental health outcomes (depression, anxiety, poor mental health …

Is There Less Opioid Abuse In States Where Marijuana Has Been Decriminalized, Either For Medicinal Or Recreational Use? A Clin-Iq, Aaron M. Wendelboe, Richard Mathew, Tana Chongsuwat, Elizabeth Rainwater, Mark A. Wendelboe, Elizabeth Wickersham Md, Ann F. Chou

Journal of Patient-Centered Research and Reviews

Opioid use, abuse, and associated mortality have reached an epidemic level. In some states, cannabis is being used to treat chronic pain. To examine the hypothesis that medical marijuana legislation may reduce adverse opioid-related outcomes if patients substitute cannabis for opioids for pain management, we conducted a clinical inquiry (Clin-IQ). We searched Ovid MEDLINE, Ovid MEDLINE In-Process, and Embase for studies using the search terms marijuana, cannabis, legal, marijuana smoking, medical marijuana, opioid-related disorders, cannabis use, medical cannabis, legal aspect, and opiate addiction. We included population-based articles published from January 1, 2012, through December 5, 2018, that assessed the relationship …

Designing The Arriving Refugee Informatics Surveillance And Epidemiology (Arive) System: A Web-Based Electronic Database For Epidemiological Surveillance, William A. Mattingly, Ruth M. Carrico, Timothy L. Wiemken, Robert R. Kelley, Rebecca A. Ford, Rahel Bosson, Kimberley A. Buckner, Julio A. Ramirez

Journal of Refugee & Global Health

Objectives: We design and implement the Arriving Refugee Informatics surVeillance and Epidemiology (ARIVE) system to improve the health of refugees undergoing resettlement and enhance existing health surveillance networks.

Materials and Methods: Using the REDCap electronic data capture software as a basis we create a refugee health database incorporating data from the Center for Disease Control and Prevention’s Electronic Disease Notification (EDN) system and domestic screening data from refugee health care providers.

Results: Domestic screening and EDN refugee health data have been integrated for 13,824 refugees resettled from 35 different countries into the state of Kentucky from the years 2013-2016.

Discussion: …

Recommendations For The Evaluation Of Cross-System Care Coordination From The Va State-Of-The-Art Working Group On Va/Non-Va Care, Kristin M. Mattocks, Kristin Cunningham, A. Rani Elwy, Erin P. Finley, Clinton Greenstone, Michelle A. Mengeling, Steven D. Pizer, Megan E. Vanneman, Michael Weiner, Lori A. Bastian

Kristin M. Mattocks

In response to widespread concerns regarding Veterans' access to VA care, Congress enacted the Veterans Access, Choice and Accountability Act of 2014, which required VA to establish the Veterans Choice Program (VCP). Since the inception of VCP, more than two million Veterans have received care from community providers, representing approximately 25% of Veterans enrolled in VA care. However, expanded access to non-VA care has created challenges in care coordination between VA and community health systems. In March 2018, the VA Health Services Research and Development Service hosted a VA State of the Art conference (SOTA) focused on care coordination. The …

Improving Care Coordination For Veterans Within Va And Across Healthcare Systems, Kristina M. Cordasco, Denise M. Hynes, Kristin M. Mattocks, Lori A. Bastian, Hayden B. Bosworth, David Atkins

Kristin M. Mattocks

The VA faces a plethora of care coordination challenges. Many Veterans have multiple conditions and providers, and many get a portion of their care in the community, a number that will only grow as recent legislation expands options for private care. These challenges have spawned new VA initiatives for redesigning care to meet them, described in this supplement in an editorial by Hosenfeld and colleagues. The VA Health Services Research and Development (HSR&D) service, in partnership with VA’s Office of Primary Care, and Office of Community Care, sponsored a State of the Art (SOTA) conference with the goals of (a) …

Understanding Maternity Care Coordination For Women Veterans Using An Integrated Care Model Approach, Kristin M. Mattocks, Aimee Kroll-Desrosiers, Rebecca L. Kinney, Sara Singer

Kristin M. Mattocks

BACKGROUND: An increasing number of women veterans are using VA maternity benefits for their pregnancies. However, because the VA does not offer obstetrical care, women must seek maternity care from non-VA providers. The growing number of women using non-VA care has increased the importance of understanding how this care is integrated with ongoing VA medical and mental health services and how perceptions of care integration impact healthcare utilization. Therefore, we sought to understand these relationships among a sample of postpartum veterans utilizing VA maternity benefits.

METHODS: We fielded a modified version of the Patient Perceptions of Integrated Care survey among …

Identifying Depression In The National Health And Nutrition Examination Survey Data Using A Deep Learning Algorithm, Jihoon Oh, Kyongsik Yun, Uri Maoz, Tae-Suk Kim, Jeong-Ho Chae

Psychology Faculty Articles and Research

Background

As depression is the leading cause of disability worldwide, large-scale surveys have been conducted to establish the occurrence and risk factors of depression. However, accurately estimating epidemiological factors leading up to depression has remained challenging. Deep-learning algorithms can be applied to assess the factors leading up to prevalence and clinical manifestations of depression.

Methods

Customized deep-neural-network and machine-learning classifiers were assessed using survey data from 19,725 participants from the NHANES database (from 1999 through 2014) and 4949 from the South Korea NHANES (K-NHANES) database in 2014.

Results

A deep-learning algorithm showed area under the receiver operating characteristic curve (AUCs) …

Increasing Actual And Perceived Burden Of Tick-Borne Disease In Maine, Robert P. Smith Md Mph, Carol A. Mccarthy Md, Susan P. Elias Phd

Journal of Maine Medical Center

Introduction: The burden of tick-borne disease (TBD) in Maine has steadily increased since the first case of Lyme disease was reported in the late 1980s. The emergence of five different agents of TBD in Maine has been challenging and confusing for clinicians and the public.

Methods: We reviewed the ecology of emerging of tick -borne disease, then reviewed risk factors for tick bites and tick-borne disease in Maine. We then compared the burden of TBD versus community-acquired comparison infections in terms of hospitalizations, deaths, and media attention.

Results and Discussion: In Maine, risk of exposure to bites from the vector …

Neighborhood-Level Predictors Of Obesity Among African American Children In California, Uche Onyeka

Journal of Social, Behavioral, and Health Sciences

The increased prevalence of childhood obesity is a major public health concern nationally and globally. Childhood obesity is primarily caused by the imbalance between caloric intake and caloric expenditure; however, its increase over the past decades may be due to environmental and behavioral factors. The purpose of the current study was to examine if any relationships existed between childhood obesity, level of physical activity, and neighborhood-level risk factors. This study used the California Health Interview Survey 2009–2014 data sets for African American children aged 5–11 years (n = 1,049). The dependent variable was body mass index (BMI) while the …

The Use Of Geospatial Modeling And Novel Diagnostics To Detect And Map Risk Factors Of Soil-Transmitted Helminths In Feira De Santana, Brazil, Ryan Harry Avery

LSU Doctoral Dissertations

Soil-transmitted helminth (STH) infections impact billions of people worldwide. The traditional STH control approach is a morbidity control strategy implementing mass drug administration (MDA) programs targeting school-aged children (SAC). In Brazil, this control strategy has decreased STH prevalence to less than 20% in most of the country and providing an opportunity to transition from the morbidity control program and towards a surveillance and response system geared towards STH elimination. Surveillance and response systems geared towards elimination require the implementation higher accuracy diagnostics to detect infection in low-transmission communities, surveillance of entire households, high-resolution modeling at the household-habitat scale, and targeted …

Blacklegged Tick (Ixodes Scapularis) Distribution In Maine, Usa, As Related To Climate Change, White-Tailed Deer, And The Landscape, Susan P. Elias

Electronic Theses and Dissertations

Lyme disease is caused by the bacterial spirochete Borrelia burgdorferi, which is transmitted through the bite of an infected blacklegged (deer) tick (Ixodes scapularis). Geographic invasion of I. scapularis in North America has been attributed to causes including 20th century reforestation and suburbanization, burgeoning populations of the white-tailed deer (Odocoileus virginianus) which is the primary reproductive host of I. scapularis, tick-associated non-native plant invasions, and climate change. Maine, USA, is a high Lyme disease incidence state, with a history of increasing I. scapularis abundance and northward range expansion. This thesis addresses the question: “To …

Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.

Electronic Theses and Dissertations

Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …

Disease And De Soto: A Bioarchaeological Approach To The Introduction Of Malaria To The Southeast Us, Kelly Marie Schaeffer

Graduate Theses and Dissertations

It is well known through documentation in historical accounts that numerous diseases were introduced to the Americas during the time of Spanish and French exploration. Diseases such as smallpox, measles and yellow fever have been credited in playing a role in the Spanish conquest of the New World through drastic Native American population decline. Many researchers have studied the biological consequences of European contact, some using direct skeletal analyses to study changes in Native American health and disease. However, one major population disease that has not been part of these discussions is malaria. This is mostly due to the current …

The Shape Study : The Survey Of Health And The Perceived Environment Study., Colette Patrice Davis

Electronic Theses and Dissertations

Introduction: Few studies have considered how an individual’s perception of their built environment may be a risk factor for being overweight or obese. Adolescents may be particularly vulnerable in the context of “impoverished environments”, which they may perceive to be difficult, dangerous, resource deficient, and unaesthetic. This study aids in clarifying how the built environment influences the risk of obesity among adolescents residing in a neighborhood in Louisville, KY. Objective: The overall objective was to conduct a cross-sectional epidemiologic pilot study among adolescents aged 12-17 years residing in West Louisville, Kentucky to evaluate the association between perceptions of …

Cancer Management In Kenya - Awareness And The Struggles Patients Face To Access Treatment, Care & Support, Ashley Nmoh

Independent Study Project (ISP) Collection

The amount of cancer cases in Africa, and Kenya specifically, are rising at an alarming rate. This study was conducted to determine the challenges that patients with cancer in Kenya face to access treatment, care and support. Thirty-nine cancer patients were interviewed and thirty cancer patients filled out a questionnaire about their experiences of having cancer in Kenya. In addition, twenty key informants were interviewed including doctors, caregivers, cancer NGO executives, a researcher, a psychologist, a National Health Insurance Fund official and a director from the Ministry of Health. A breast cancer awareness survey was also administered to fifty-nine women …

The Business Cycle And Health: An Analysis Of How Macroeconomic Conditions Impact Health Outcomes In The U.S., Talitha Kumaresan

Honors Theses

The U.S. spends about twice as much per person on healthcare, yet the disease burden remains higher in the U.S. than in comparable countries (Sawyer and Cox 2018; Sawyer and Gonzales 2017). Although health status is perceived to be an outcome of individual decision making, the business cycle also affects health. While the effect of macroeconomic shocks on health outcomes has been studied extensively, results remain inconclusive. This analysis uses longitudinal data over 30 years and panel data models to examine the effect of macroeconomic conditions on obesity, diabetes, hypertension, depression, congestive heart failure, and heart attack or myocardial infarction. …

Determinants Of Severe Maternal Morbidity And Its Racial/Ethnic Disparities In New York City, 2008–2012, Renata E. Howland, Meghan Angley, Sang Hee Won, Wendy Wilcox, Hannah Searing, Sze Yan Liu, Emily White Johansson

Department of Public Health Scholarship and Creative Works

Objectives Severe maternal morbidity (SMM) is an important indicator for identifying and monitoring efforts to improve maternal health. Studies have identified independent risk factors, including race/ethnicity; however, there has been limited investigation of the modifying effect of socioeconomic factors. The study aims were to quantify SMM risk factors and to determine if socioeconomic status modifies the effect of race/ethnicity on SMM risk. Methods We used 2008–2012 NYC birth certificates matched with hospital discharge records for maternal deliveries. SMM was defined using an algorithm developed by the Centers for Disease Control and Prevention. Mixed-effects logistic regression models estimated SMM risk by …

Prehypertensive Risk Among African-American Undergraduates: Do The Extra Pounds Really Matter?, Cecile N. Yancu, Amber Debono, Anna K. Lee, Correll Mcrae, Daphne Witherspoon

Journal of Health Disparities Research and Practice

The objective of this study is to examine prehypertension among young African American adults and evaluate the predictive value of easily obtained standard measures of adiposity. Data for this study of 155 primarily African-American undergraduates was collected between April 2010-11. Participants provided family health history and anthropometric measures, including body weight, body mass index (BMI), and waist to hip (WHR) ratio. Percentages were calculated for demographics. The average systolic blood pressure measured over two time periods within a single semester generated prehypertension rates. Univariate and multivariate logistic regression examined the impact of BMI, WHR, weight, and family medical history on …

Care Of Acute Conditions And Chronic Diseases In Canada And The United States: Rapid Systematic Review And Meta-Analysis, Keren M. Escobar, Dorian Murariu, Sharon Munro, Kevin M. Gorey

Social Work Publications

This study tested the hypothesis that socioeconomically vulnerable Canadians with diverse acute conditions or chronic diseases have health care access and survival advantages over their counterparts in the USA. A rapid systematic review retrieved 25 studies (34 independent cohorts) published between 2003 and 2018. They were synthesized with a streamlined meta-analysis. Very low-income Canadian patients were consistently and highly advantaged in terms of health care access and survival compared with their counterparts in the USA who lived in poverty and/or were uninsured or underinsured. In aggregate and controlling for specific conditions or diseases and typically 4 to 9 comorbid factors …

Multiplicative Advantages Of Hispanic Men Living In Hispanic Enclaves: Intersectionality In Colon Cancer Care: A Research Note, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey

Social Work Publications

We examined Hispanic enclave paradoxical effects on cancer care among socioeconomically vulnerable people in pre-Obamacare California. We conducted a secondary analysis of a historical cohort of 511 Hispanic and 1,753 non-Hispanic white people with colon cancer. Hispanic enclaves were neighborhoods where 40% or more of the residents were Hispanic, mostly first-generation Mexican American immigrants. An interaction of ethnicity, gender, and Hispanic enclave status was observed such that the protective effects of living in a Hispanic enclave were larger for Hispanic men, particularly married Hispanic men, than women. Risks were also exposed among other study groups: the poor, the inadequately insured, …

Fraud Detection Protocol For Web-Based Research Among Men Who Have Sex With Men: Development And Descriptive Evaluation, April M. Ballard, Trey Cardwell, April M. Young

Epidemiology and Environmental Health Faculty Publications

Background: Internet is becoming an increasingly common tool for survey research, particularly among “hidden” or vulnerable populations, such as men who have sex with men (MSM). Web-based research has many advantages for participants and researchers, but fraud can present a significant threat to data integrity.

Objective: The purpose of this analysis was to evaluate fraud detection strategies in a Web-based survey of young MSM and describe new protocols to improve fraud detection in Web-based survey research.

Methods: This study involved a cross-sectional Web-based survey that examined individual- and network-level risk factors for HIV transmission and substance use among young MSM …

Multiplicative Advantages Of Hispanic Men Living In Hispanic Enclaves: Intersectionality In Colon Cancer Care, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey

The Journal of Sociology & Social Welfare

We examined Hispanic enclave paradoxical effects on cancer care among socioeconomically vulnerable people in pre-Obamacare California. We conducted a secondary analysis of a historical cohort of 511 Hispanic and 1,753 non-Hispanic white people with colon cancer. Hispanic enclaves were neighborhoods where 40% or more of the residents were Hispanic, mostly first-generation Mexican American immigrants. An interaction of ethnicity, gender and Hispanic enclave status was observed such that the protective effects of living in a Hispanic enclave were larger for Hispanic men, particularly married Hispanic men, than women. Risks were also exposed among other study groups: the poor, the inadequately insured, …

Predictors And Health Outcomes Of Treatment-Resistant Depression Among Adults With Chronic Non-Cancer Pain Conditions And Major Depressive Disorder, Drishti Shah

Graduate Theses, Dissertations, and Problem Reports

Understanding major depressive disorder (MDD) as a comorbidity in patients with chronic non-cancer pain conditions (CNPC) is of importance because of the high prevalence and well documented bi-directional relationship between MDD and pain. Furthermore, presence of CNPC among adults with MDD often reduces benefits of antidepressant therapy, thereby increasing the possibility of treatment resistance. Treatment-resistant depression (TRD) commonly defined as insufficient response to multiple antidepressant trials, often worsens depression and pain symptoms and can amplify the clinical and economic burden among adults with CNPC and MDD. Additionally, long-term opioid therapy (LTOT) may be prescribed at a higher rate to adults …