Epidemiology Commons^™

Managing Stress: A Study Of Stress Response Mechanisms In Mycobacteria, Augusto C. Hunt Serracin

Biology Dissertations - Archive

Mycobacteria encompass many pathogenic species known to cause severe disease in humans. A well-known example is Mycobacterium tuberculosis (Mtb), the causative agent of the lung disease tuberculosis, which kills millions of humans worldwide yearly. Pathogenic mycobacteria like Mtb are challenging to treat because of their innate ability to adapt to environmental stress. Their unique cell physiology and conserved stress responses allow them to combat biological insults, regulate growth, and regulate genes involved in stress; all these responses increase tolerance to antibiotics. The current therapies to treat mycobacterial infections are lengthy and, at times, unsuccessful, partly due to antibiotic tolerance. A …

Resilience Of Mental Health Services Amidst Ebola Disease Outbreaks In Africa, Frankline Sevidzem Wirsiy, Nancy B. Tahmo, Lambed Tatah, David Brett-Major

Journal Articles: Epidemiology

INTRODUCTION: Health systems including mental health (MH) systems are resilient if they protect human life and produce better health outcomes for all during disease outbreaks or epidemics like Ebola disease and their aftermaths. We explored the resilience of MH services amidst Ebola disease outbreaks in Africa; specifically, to (i) describe the pre-, during-, and post-Ebola disease outbreak MH systems in African countries that have experienced Ebola disease outbreaks, (ii) determine the prevalence of three high burden MH disorders and how those prevalences interact with Ebola disease outbreaks, and, (iii) describe the resilience of MH systems in the context of these …

Population Burden Of Rare Infectious And Inflammatory Diseases Of The Heart, Meera Marji

Theses and Dissertations--Epidemiology and Biostatistics

Rare diseases of the heart, such as infective endocarditis (IE), myocarditis, and pericarditis, have earned limited attention in cardiovascular research despite their potential for severe morbidity and mortality. Amidst the opioid crisis in the United States, there has been a notable increase in endocarditis hospitalizations among people who inject drugs. Kentucky, at the epicenter of the opioid epidemic, lacks available data on IE hospitalizations. Moreover, the COVID-19 pandemic has introduced unprecedented challenges to healthcare systems, influencing hospitalizations and healthcare utilization patterns. While trends before, during, and after the pandemic have been extensively studied for common cardiovascular diseases, such as heart …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Exploring The Dynamics Of Attracting And Retaining Acute Care Psychiatric Registered Nurses: An In-Depth Analysis Using Focus Groups, Kendra Ratnapradipa, Julia F. Houfek, Phoebe Gearhart, Erin O. Scheider, Christine Chasek, Danae Dinkel, Katrina M. Cordts, Marley Doyle, Priyanka Chaudhary, Deepanjali Bhale, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

The recruitment and retention of in-patient psychiatric mental health registered nurses (PMH-RNs) remains a challenge. This qualitative study sought to identify factors impacting the recruitment and retention of PMH-RNs in acute-care settings. Participants (N = 15) were recruited for focus groups including one with in-patient unit administrators (n = 4), two with current PMH-RNs (n = 7), and two with nursing students (n = 4). Data were analyzed using a directed content analysis approach. Participants were informed about the study’s purpose, procedures, potential risks, and benefits, and they provided verbal consent before participating. Administrators emphasized a …

Plasma Per-And Polyfluoroalkyl Substance (Pfas) Mixtures And Maternal Cardiometabolic Health, Yuting Wang

Dartmouth College Ph.D Dissertations

Food is a common exposure pathway to per- and polyfluoroalkyl substances (PFAS) but dietary factors related to PFAS concentrations in pregnant people have not been adequately evaluated. PFAS have been linked to the increased risk of gestational hypertension, preeclampsia, and adiposity. However, less is known regarding the effect of PFAS mixtures on blood pressure (BP) trajectories in normotensive pregnancies or weight retention postpartum. We used data from the New Hampshire Birth Cohort Study (NHBCS) to examine dietary intake and PFAS concentrations and associations of PFAS with BP trajectories and postpartum weight retention. PFAS concentrations were measured in plasma collected at …

Sleep, Sedentary Time, And Physical Activity In Heart Failure Subtypes: Multi-Ethnic Study Of Atherosclerosis (Mesa), Demi M. Nott

UNF Graduate Theses and Dissertations

INTRODUCTION: Previous studies have examined the associations between physical activity (PA), sedentary time (ST), and sleep on the risk of heart failure (HF). The primary aim of this study was to examine PA, ST, and sleep quality (SQ) in those diagnosed with preserved ejection fraction HF (HFpEF) and reduced ejection fraction HF (HFrEF). The secondary aim of this study was to examine these relationships in those with and without HF, independent of sub-type.

METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) collected data from 6,814 adults from a diversified cohort who range in age from 45 to 84. Subjects were classified …

Predictive Power Of Wastewater For Nowcasting Infectious Disease Transmission: A Retrospective Case Study Of Five Sewershed Areas In Louisville, Kentucky., Fayette Klaassen, Rochelle H. Holm, Ted Smith, Ted Cohen, Aruni Bhatnagar, Nicolas A. Menzies

Faculty and Staff Scholarship

Background: Epidemiological nowcasting traditionally relies on count surveillance data. The availability and quality of such count data may vary over time, limiting representation of true infections. Wastewater data correlates with traditional surveillance data and may provide additional value for nowcasting disease trends. Methods: We obtained SARS-CoV-2 case, death, wastewater, and serosurvey data for Jefferson County, Kentucky (USA), between August 2020 and March 2021, and parameterized an existing nowcasting model using combinations of these data. We assessed the predictive performance and variability at the sewershed level and compared the effects of adding or replacing wastewater data to case and death reports. …

Associations Between Physical Activity Levels And Physical And Mental Health In Military Veterans., Troy Hubert

Theses and Dissertations--Psychology

Research suggests that higher rates of health conditions are associated with lower levels of physical activity, but this association is not well characterized in U.S. Military Veterans. The current study utilized a sample of U.S. military veterans (n = 3,989) from the 2019-2020 National Health and Resiliency in Veterans Study (NHRVS). Physical activity levels (insufficient, moderate, and active), physical and mental health were evaluated with a variety of self-report questionnaires. After controlling for covariates, veterans with any disability, asthma, chronic pain, diabetes, high cholesterol, and stroke were significantly less likely to report sufficient physical activity compared to insufficient physical …

Impacts Of Climate Change On Vector-Borne Disease Burden In The United States: Exploring The Epidemiological Evidence, Leah V. Loetman

Honors Theses

Climate change models predict shifts in vector-borne diseases (VBDs) around the world, including in the United States. However, to my knowledge there has yet to be a comprehensive descriptive epidemiological study examining prevalence, geographic distribution, and trends for all tick- and mosquito-borne diseases in the United States. I compiled data from the U.S. Centers for Disease Control (CDC), which publishes yearly case numbers for 17 vector-borne diseases. However, these publications depend on a scattered framework of state regulations regarding disease reporting. I compiled data from the CDC to determine the current geographic distribution, prevalence, and trends of tick- and mosquito-borne …

Exposition Professionnelle Des Femmes Aux Substances Chimiques : Amélioration D’Une Matrice Emploi Exposition Existante Pour Fournir Des Estimations Spécifiques Au Sexe : Rapport Abrégé, Vikki Ho, Chelsea Almadin, France Labrèche, Mark Goldberg, Marie-Élise Parent, Jack Siemiatycki, Jérôme Lavoué

Rapports de recherche scientifique

Il est reconnu que les femmes et les hommes ont des profils professionnels différents qui peuvent donc se traduire par des risques de maladie professionnelle différents. Pourtant, la plupart de nos connaissances actuelles sur les maladies professionnelles découlent d'études menées auprès des hommes. Or, les femmes représentent actuellement 48 % de la population active au Québec. La santé des femmes dans l’environnement de travail demeure un domaine sous-étudié et nous sommes particulièrement freinés par le manque de compréhension de l'impact du genre sur l'exposition en milieu de travail. Il a été démontré que l'attribution des tâches et les conditions de …

Occupational Exposures Of Women To Chemical Substances: Improvement Of An Existing Job Exposure Matrix To Provide Sex-Specific Estimations Of Exposure, Vikki Ho, Chelsea Almadin, France Labrèche, Mark Goldberg, Marie-Élise Parent, Jack Siemiatycki, Jérôme Lavoué

Rapports de recherche scientifique

Il est reconnu que les femmes et les hommes ont des profils professionnels différents qui peuvent donc se traduire par des risques de maladie professionnelle différents. Pourtant, la plupart de nos connaissances actuelles sur les maladies professionnelles découlent d'études menées auprès des hommes. Or, les femmes représentent actuellement 48 % de la population active au Québec. La santé des femmes dans l’environnement de travail demeure un domaine sous-étudié et nous sommes particulièrement freinés par le manque de compréhension de l'impact du genre sur l'exposition en milieu de travail. Il a été démontré que l'attribution des tâches et les conditions de …

Measured Air Quality Impacts After Teaching Parents About Cooking Ventilation With A Video: A Pilot Study, Stephanie M. Holm, Brett C. Singer, Mi-Suk Kang Dufour, Woody Delp, James E. S. Nolan, P. Jacob Bueno De Mesquita, Et Al.

Arts & Sciences Faculty Publications

Background

Cooking-related emissions contribute to air pollutants in the home and may influence children’s health outcomes.

Objective

In this pilot study, we investigate the effects of a cooking ventilation intervention in homes with gas stoves, including a video-based educational intervention and range hood replacement (when needed) in children’s homes.

Methods

This was a pilot (n = 14), before-after trial (clinicaltrials.gov #NCT04464720) in homes in the San Francisco Bay Area that had a school-aged child, a gas stove, and either a venting range hood or over-the-range microwave/hood. Cooking events, ventilation use, and indoor air pollution were measured in homes for …

High Prevalence Of Trypanosoma Cruzi Infection In Raccoons (Procyon Lotor) And Associated Risk To Humans In Central Illinois, Esther Onuselogu

Masters Theses

Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, remains a neglected tropical disease and a growing health threat in the United States. Raccoons (Procyon lotor) often coexist with humans in urban and suburban areas and serve as reservoir hosts for T. cruzi. While T. cruzi is rare in humans and domestic animals in the U.S., it is common in wildlife species, particularly raccoons and Virginia opossums (Didelphis virginiana). This study aimed to assess the prevalence of T. cruzi infection in the raccoon population of Central Illinois and evaluate the risk of transmission to humans. …

Evaluating The Performance Of Flukecatcher At Detecting Urogenital Schistosomiasis, Louis Fok, Berhanu Erko, David Brett-Major, Abebe Animut, M. Jana Broadhurst, Daisy Dai, John Linville, Bruno Levecke, Yohannes Negash, Abraham Degarege

Journal Articles: Epidemiology

Urine filtration microscopy (UFM) lacks sensitivity in detecting low-intensity Schistosoma haematobium infections. In pursuit of a superior alternative, this study evaluated the performance of FlukeCatcher microscopy (FCM) at detecting S. haematobium eggs in human urine samples. Urine samples were collected from 572 school-age children in Afar, Ethiopia in July 2023 and examined using UFM and FCM approaches. Using the combined UFM and FCM results as a reference, the sensitivity, negative predictive value, and agreement levels for the two testing methods in detecting S. haematobium eggs in urine samples were calculated. The sensitivity and negative predictive value of detecting S. haematobium …

A Structured Review Of The Associations Between Breast Cancer And Exposures To Selected Organic Solvents, Sydney Westra, Mark S. Goldberg, France Labrèche, Jill Baumgartner, Vikki Ho

Revues de littérature, synthèses de connaissances

Introduction

Our objective was to identify published, peer-reviewed, epidemiological studies that estimated associations between the risk of developing or dying from malignant breast cancer and past exposure to selected organic solvents with reactive metabolites, to delineate the methods used and to synthesize the results.

Content

We undertook a structured review of case-control and cohort studies used to investigate breast cancer risk and exposure to selected organic solvents that produce reactive metabolites in the body. We used SCOPUS, MEDLINE (Ovid) and Web of Science databases from 1966 to December 31, 2023 to identify epidemiological studies that estimated associations between the risk …

Cardiometabolic Genomics And Pharmacogenomics In Filipino Americans: A Cross-Sectional Study, Khalifa Y. Alrajeh

Theses and Dissertations

Background: Heart disease remains a leading cause of death in the country, with significant ethnic disparities. Filipino Americans (FAs), the third-largest Asian subgroup in U.S., face an elevated burden of dyslipidemia, a primary modifiable risk factor for heart disease. Objectives: This community-based study addresses critical knowledge gaps by characterizing the cardiometabolic and genetic factors contributing to dyslipidemia among FAs and implications for personalized cardiovascular drug therapies, particularly statin pharmacogenomics (PGx). Methods: We characterized dyslipidemia prevalence in FAs and major ethnic subgroups using nationally representative NHANES data. We examined associations between uric acid (UA) levels and lipid profiles, …

Disparities In Thyroid Cancer Diagnosis Based On Residence And Distance From Medical Facility, Sunita Regmi, Evi A. Farazi, Elizabeth Lyden, Anupam Kotwal, Apar Kishor Ganti, Whitney Goldner

Journal Articles: Epidemiology

CONTEXT: Rural-urban disparities have been reported in cancer care, but data are sparse on the effect of geography and location of residence on access to care in thyroid cancer.

OBJECTIVE: To identify impact of rural or urban residence and distance from treatment center on thyroid cancer stage at diagnosis.

METHODS: We evaluated 800 adults with differentiated thyroid cancer in the iCaRe2 bioinformatics/biospecimen registry at the Fred and Pamela Buffett Cancer Center. Participants were categorized into early and late stage using AJCC staging, and residence/distance from treating facility was categorized as short (≤ 12.5 miles), intermediate (> 12.5 to < 50 miles) or long (≥ 50 miles). Multivariable logistic regression was used to identify factors associated with late-stage diagnosis.

RESULTS: Overall, …

Ever Use Of Telehealth In Nebraska By March 2021: Cross-Sectional Analysis, Lisa C. Smith, George Johnson, Snehal Jadhav, Josiane Kabayundo, Muskan Ahuja, Hongmei Wang, Kendra L. Ratnapradipa

Journal Articles: Epidemiology

BACKGROUND: Nationally, COVID-19 spurred the uptake of telehealth to facilitate patients' access to medical care, especially among individuals living in geographically isolated areas. Despite the potential benefits of telehealth to address health care access barriers and enhance health outcomes, there are still disparities in the accessibility and utilization of telehealth services. Hence, identifying facilitators and barriers to telehealth should be prioritized to ensure that disparities are mitigated rather than exacerbated.

OBJECTIVE: This study aims to identify factors associated with ever use of telehealth in Nebraska, a primarily rural state with a significant portion of its population living in nonmetropolitan areas. …

Clinical Sensitivity And Time-To-Result Of A Cascaded Pooled Testing Approach For Assessing The Prevalence And Intensity Of Schistosoma Haematobium Infection, Abraham Degarege, Bruno Levecke, Yohannes Negash, Abebe Animut, Berhanu Erko

Journal Articles: Epidemiology

BACKGROUND: This study compared the clinical sensitivity and the time-to-result of an individual testing (IT) and a cascaded pooled testing approach (CPT; a positive test result in a pooled sample triggers examination of smaller-sized pools or individual samples) for assessing the prevalence and the intensity of Schistosoma haematobium infection. We also compared the sensitivity of the CPT in detecting S. haematobium infection when deploying urine filtration microscopy (UFM) vs. urine reagent strips (URS), and testing 10 mL vs. 15 mL of urine.

METHODOLOGY/PRINCIPAL FINDINGS: Between October 2021 and April 2022, S. haematobium eggs were counted in urine samples collected from …

Mail-Based Or Home Delivery Services: Preferences Among People Who Inject Drugs In Appalachian Kentucky, Su Su Zin

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Aim: To explore acceptability of delivery-based syringe services program (SSP) among people who inject drug (PWID) in Eastern Kentucky and compare those who wanted to participate in delivery-based SSP to those who did not.

Methods: This was a cross-sectional analysis of data from PWID who injected drugs to get high in the past 30 days (n=246) collected during the baseline assessment administered to the Gateway2Health cohort. Chi-square tests, t-tests, univariate and multivariable logistic regressions were calculated between independent variables and the outcome variable (likelihood of participating in a delivery-based SSP).

Results: 52.9% of PWID reported being likely to participate in …

Novel Cannabinoid Use Among Young Adults In Lexington, Kentucky, Victoria A. Hamilton

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Purpose: The purpose of this study was to implement a survey to estimate the prevalence of novel cannabinoid use among young adults in Lexington, Kentucky, and to examine modes of use and motivations for novel cannabinoid use. The primary hypothesis of this study was that many respondents would indicate medical reasons for using novel cannabinoids.

Methods: A cross-sectional primary data analysis of 101 young adults in Lexington, Kentucky to determine prevalence of lifetime novel cannabinoid use, past 30-day novel cannabinoid use, mode of use, motivation for use, and related demographic characteristics. Univariate and bivariate analysis were produced using the PROC …

The Association Of Skin Cancer Prevention Knowledge, Sun-Protective Attitudes, And Sun-Protective Behaviors In A Navy Population, Rachel Newnam, Uyen Le-Jenkins, Carolyn Rutledge, Craig Cunningham

Ellmer School of Nursing Faculty Publications

Introduction: U.S. Navy service members are primarily between the ages of 18 and 30 years and often required to be outside for extended periods of time in geographical locations with increased and often unfamiliar ultraviolet indexes that collectively increase their risk for skin cancer. Skin cancer is the country's most common form of cancer, yet there is a paucity of skin cancer prevention literature, especially within the U.S. Navy. The purpose of this study was to describe skin cancer risk and skin cancer prevention "cues-to-action" and to determine if skin cancer prevention knowledge was associated with sun-protective attitudes (e.g., prevention …

Recent Trends In Stimulant Prescribing In Kentucky, 2021-2023, Jordan Shannon

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract

Introduction

Prescription stimulants have a long history of clinical use dating as far back as the 1930s. In the United States stimulant prescribing rates have steadily climbed over the last 3 decades. The primary objective is to describe recent (2021-2023) prescribing trends of stimulant medications in the Commonwealth of Kentucky

Methods

Prescription data collected from Kentucky’s prescription drug monitoring (PDMP) database known as the Kentucky All Schedule Prescription Electronic Reporting System (KASPER). Annual and quarterly trends in stimulant prescribing between 2021-2023 were calculated, examined by age, sex, and geographic location.

Results

Stimulant prescribing increased by ~15% where the majority …

The Performance Of Marginal Modeling Methods For Rare Events With Application To Opioid Overdose Mortality And Morbidity, Shawn Nigam

Theses and Dissertations--Epidemiology and Biostatistics

Opioid misuse is a nationwide epidemic, with Kentucky having one of the highest opioid overdose-related fatality rates across all US states. These rates have increased significantly over the past decade, with particularly large increases during the COVID-19 pandemic. This dissertation aims to study the behavior of these increases and the methods for the marginal modeling of count outcomes related to opioid overdose.

Opioid overdose-related fatality rates in Kentucky increased significantly during the COVID-19 pandemic. In this chapter, we characterize the changes in opioid overdose fatality rates in Kentucky and identify associations between potential factors and fatality rates. County-level opioid overdose …

Availability, Use, And Impact Of Workplace Mental Health Supports During The Covid-19 Pandemic In A Canadian Cohort Of Healthcare Workers, Shannon Ruzycki, Anil Adisesh, Igor Burstyn, Quentin Durand-Moreau, France Labreche, Tanis Zadunayski, Nicola Cherry

Études primaires

We investigated the availability and use of workplace mental health (MH) supports during the COVID-19 pandemic in a Canadian cohort of healthcare workers (HCW) and measured anxiety and depression by the Hospital Anxiety and Depression Scale (HADS) completed at four contacts 2020–2022. Reports were available for 4400 HCW working with patients. Half the HCWs had a clinically significant HADS score at one or more contacts Access to MH supports increased during the pandemic, with 94% reporting access to some workplace support by 2022: 47% had made use of at least one support. 25% of those with high HADS scores used …

Efficacy Of Praziquantel In Treating Schistosoma Haematobium Infection Among Ethiopian Children, Louis Fok, David Brett-Major, Berhanu Erko, John Linville, Hongying Dai, Yohannes Negash, Abebe Animut, Abraham Degarege

Journal Articles: Epidemiology

Background/Objectives: Praziquantel is a cornerstone of schistosomiasis control and elimination efforts. Continued surveillance of praziquantel efficacy is needed to monitor for the development of resistance, as well as to help public health officials gauge the effect of mass praziquantel administration on schistosomiasis control in communities, since it is the only drug used in schistosomiasis control programs. The objective of this study was to assess the praziquantel cure rate and egg reduction rate against urogenital schistosomiasis.

Methods: This study enrolled 977 children from 12 villages in Afar and Gambella, Ethiopia, who provided urine samples that were checked for Schistosoma haematobium …

Implementing A Nurse-Driven Clostridium Difficile Screening Protocol, Sandrela Magnuson

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: Clostridium difficile infection (CDI) is a prevalent infection often contracted in hospitals. CDI is also increasingly originating from community settings. In addition to the health risks associated with CDI, diagnosis of a hospital-acquired CDI can have a significant financial impact on hospital systems. When hospital acquired, hospital systems are no longer reimbursed by payers. Secondary to the increasing prevalence of community-acquired CDI, mechanisms for early detection and isolation are warranted.

Local Problem: J.W. Ruby Memorial Hospital has an integrated Clostridium difficile (C. difficile) electronic health record (EHR) screening questionnaire that requires updating to align with current guidelines.

Purpose: …

Geospatial Hotspots And Coldspots In Us Cancer Disparities And Associated Risk Factors, 2004-2008 To 2014-2018, Lei Guo, M. Courtney Hughes, Margaret E. Wright, Alyssa H. Harris, Meredith C. Osias

Faculty Articles, Papers, and Other Scholarship

Introduction

Despite declining cancer death rates in the US, cancer remains the second deadliest disease and disparities persist. Although research has focused on identifying risk factors for cancer deaths and associated disparities, few studies have examined how these relationships vary over time and space. The primary objective of this study was to identify cancer mortality hot spots and cold spots — areas where cancer death rates decreased less than or more than neighboring areas over time. A secondary objective was to identify risk factors of cancer mortality hot spots and cold spots.

Methods

We analyzed county-level cancer death rates from …

Different Cohort, Disparate Results: Selection Bias Is A Key Factor In Autopsy Cohorts, Kathryn Gauthreaux, Walter A. Kukull, Karin B. Nelson, Charles Mock, Yen-Chi Chen, Kwun C. G. Chan, David W. Fardo, Yuriko Katsumata, Erin L. Abner, Peter T. Nelson

Neurology Faculty Publications

INTRODUCTION: Research-oriented autopsy cohorts provide critical insights into dementia pathobiology. However, different studies sometimes report disparate findings, partially because each study has its own recruitment biases. We hypothesized that a straightforward metric, related to the percentage of research volunteers cognitively normal at recruitment, would predict other inter-cohort differences.

METHODS: The National Alzheimer’s Coordinating Center (NACC) provided data on N = 7178 autopsied participants from 28 individual research centers. Research cohorts were grouped based on the proportion of participants with normal cognition at initial clinical visit.

RESULTS: Cohorts with more participants who were cognitively normal at recruitment contained more individuals who …