Epidemiology Commons^™

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.

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, …

New Malignancies After Squamous Cell Carcinoma And Melanomas: A Population-Based Study From Norway, Trude E. Robsahm, Margaret R. Karagas, Judy R. Rees, Astri Syse

Dartmouth Scholarship

Skin cancer survivors experience an increased risk for subsequent malignancies but the associated risk factors are poorly understood. This study examined the risk of a new primary cancer following an initial skin cancer and assessed risk factors associated with second primary cancers.

Troubled By Heterogeneity? Control, Infrastructure & Participation In Social Epidemiology And Life Course Development, Peter J. Taylor

Working Papers on Science in a Changing World

This working paper presents the panels of a poster prepared for a conference, “Complex Systems, Health Disparities, and Population Health: Building Bridges,” held at NIH in Bethesda, MD in February 2014. Just as poster presenters hope viewers stop and talk, my aim in sharing the panels as a working paper is to elicit more conversation about different kinds of heterogeneity and the ways they are addressed or suppressed in social epidemiology and life course development. The thinking behind this concern is as follows. The two foundational developments of modern biology—the theories of evolution by natural selection and the genetic basis …

Factors Associated With Tuberculin Skin Test Positivity Prevalence In U.S. Medical Laboratory Microbiologists, Julie Ann West

Walden Dissertations and Doctoral Studies

Prior research has indicated that healthcare personnel (HCP) who work in areas where Mycobacterium tuberculosis poses an occupational hazard are at high risk of tuberculin skin test (TST) positivity and subsequent conversion to active tuberculosis (TB). U.S. medical laboratory microbiologists confront similar hazards but have not been studied outside of the HCP aggregate. The purpose of this study was to fill this gap by examining the relationships between the predictor variables of self-reported history of bacille Calmette-Guerin (BCG) immunization, place of birth, and years of laboratory experience and the outcomes of self-reported lifetime TST positivity, preventive treatment noninitiation, and barriers …

Relationship Between Altitude And Lithium In Groundwater In The United States Of America: Results Of A 1992–2003 Study, Rebekah S. Huber, Namkug Kim, Carl E. Renshaw, Perry F. Renshaw, Douglas Kondo

Dartmouth Scholarship

Therapeutic dosages of lithium are known to reduce suicide rates, which has led to investigations of confounding environmental risk factors for suicide such as lithium in groundwater. It has been speculated that this might play a role in the potential relationship between suicide and altitude. A recent study in Austria involving geospatial analysis of lithium in groundwater and suicide found lower levels of lithium at higher altitudes. Since there is no reason to suspect this correlation is universal given variation in geology, the current study set out to investigate the relationship between altitude and lithium in groundwater in the United …

Exploration Of The Genetic Epidemiology Of Asthma: A Review, With A Focus On Prevalence In Children And Adolescents In The Caribbean, A. Mohan, A. J. Roberto, B. C. Whitehill, A. Mohan, A. Kumar

Biological Sciences Faculty Publications

Asthma is a chronic disease caused by the inflammation of the main air passages of the lungs. This paper outlines a review of the published literature on asthma. While a few studies show a trend of rising asthma cases in the Caribbean region, even fewer have explored the genetic epidemiological factors of asthma. This is a literature review that seeks to sum the body of knowledge on the epidemiology of asthma. Specifically, the major objective of the literature review is to provide a unified information base on the current state of factors involved in the genetic epidemiology of asthma. The …

Proximate And Evolutionary Insights Into The Epigenetics Of Posttraumatic Stress Disorder, Levent Sipahi

Wayne State University Dissertations

Posttraumatic stress disorder (PTSD) is an important medical and social condition. Although the vast majority of individuals are exposed to traumatic events within their lifetime, a minority subsequently develop diagnosable PTSD. What underlies differential risk and resiliency in the face of trauma is an ongoing research and clinical question with implications for prevention and treatment. Recent work has revealed a putative role of epigenetic variation and modification - most notably DNA methylation - in the etiology of PTSD. That DNA methylation is stable, yet modifiable in response to lived experiences, makes it a strong candidate to mechanistically explain the ontogeny …

The Effect Of Marriage On Stage At Diagnosis And Survival In Women With Cervical Cancer, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Marriage is associated with improved health outcomes for many conditions. Married persons enjoy financial stability, social and emotional support, and tend to have better control of health risk behaviors compared to the unmarried. The marriage scene is changing continuously. Americans are marrying less or delaying the engagement to an older age. They are divorcing more, they choose cohabitation as an alternative to marriage, or engage in premarital relationships. As a consequence, barely half of Americans were married in 2011 compared to close to three quarters of Americans were married in the sixties. With the increase of the unmarried population - …

Asthma And Risk Of Non-Respiratory Tract Infection: A Population-Based Case-Control Study, Duk Won Bang, Hyeon J Yang, Eell Ryoo, Majdi N. Al-Hasan, Brian Lahr, Larry M. Baddour, Barbara P. Yawn, Young J. Juhn

Internal Medicine Faculty Publications

OBJECTIVES: Asthmatics have increased risks of airway-related infections. Little is known about whether this is true for non-airway-related serious infections such as Escherichia coli bloodstream infection (BSI). We assessed whether asthma is associated with a risk of developing community-acquired E coli BSI.

DESIGN: The study was designed as a population-based retrospective case-control study.

SETTING: This population-based study was conducted in Olmsted County, Minnesota.

PARTICIPANTS: The study included 259 all eligible community-acquired E coli BSI cases in Olmsted County, MN between 1998 and 2007 and 259 birthday-matched, gender-matched and residency-matched controls.

PRIMARY AND SECONDARY OUTCOME MEASURES: Only community-acquired E coli BSI …

Mapping Disease At An Approximated Individual Level Using Aggregate Data: A Case Study Of Mapping New Hampshire Birth Defects, Xun Shi, Stephanie Miller, Kevin Mwenda, Akikazu Onda

Dartmouth Scholarship

Limited by data availability, most disease maps in the literature are for relatively large and subjectively-defined areal units, which are subject to problems associated with polygon maps. High resolution maps based on objective spatial units are needed to more precisely detect associations between disease and environmental factors. Method: We propose to use a Restricted and Controlled Monte Carlo (RCMC) process to disaggregate polygon-level location data to achieve mapping aggregate data at an approximated individual level. RCMC assigns a random point location to a polygon-level location, in which the randomization is restricted by the polygon and controlled by the background (e.g., …

Sessile Serrated Adenomas In The Proximal Colon Are Likely To Be Flat, Large And Occur In Smokers, Tarun Rustagi, Priya Rangasamy, Matthew Myers, Melinda Sanders, Haleh Vaziri, George Y. Wu, John W. Birk, Petr Protiva, Joseph C. Anderson

Dartmouth Scholarship

Aim: To examine the epidemiology and the morphology of the proximal sessile serrated adenomas (SSAs).

Methods: We conducted a retrospective study to identify patients with SSAs using a university-based hospital pathology database query from January 2007 to April 2011. Data collected included: age, gender, ethnicity, body mass index, diabetes, smoking, family history of colorectal cancer, aspirin, and statin use. We collected data on morphology of SSAs including site (proximal or distal), size, and endoscopic appearance (flat or protuberant). We also compared proximal SSAs to proximal tubular adenomas detected during same time period.

Maximizing The Delivery Performance Of Point-Of-Care Cd4+ T-Cell Counting Tests In Resource-Limited Settings - A Policy Brief, Nan Kong, J. Paul Robinson, Fenggang Yang

Purdue Policy Research Institute (PPRI) Policy Briefs

Managing HIV/AIDS presents challenges to public health policymakers, frontline workers, and researchers worldwide. A key strategy in the disease management is early diagnosis and rapid treatment initiation. While the technological field of point‐of‐care HIV/AIDS diagnostics has advanced significantly in the past two decades, several critical issues remain that hinder the deployment of point‐of‐care testing devices in resource‐deprived settings. In this policy brief, we discuss these issues, including technological specifics of point‐of‐care CD4⁺ T‐cell counting approaches and requirements of deploying them. We also discuss cultural and religious concerns on the deployment. At the end of the brief, we propose a …

National Estimates Of Emergency Department Visits For Pediatric Severe Sepsis In The United States, Sara Singhal, Mathias W. Allen, John-Ryan Mcannally, Kenneth S. Smith, John P. Donnelly, Henry E. Wang

Emergency Medicine Faculty Publications

Objective. We sought to determine the characteristics of children presenting to United States (US) Emergency Departments (ED) with severe sepsis.

Study design. Cross-sectional analysis using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS). Using triage vital signs and ED diagnoses (defined by the International Classification of Diseases, Ninth Revision codes), we identified children(triage fever or ICD-9 infection) and organ dysfunction (triage hypotension or ICD-9 organ dysfunction).

Results. Of 28.2 million pediatric patients presenting to US EDs each year, severe sepsis was present in 95,055 (0.34%; 95% CI: 0.29-0.39%). Fever and respiratory infection were the most common indicators of …

When Pictures Waste A Thousand Words: Analysis Of The 2009 H1n1 Pandemic On Television News, Westerly Luth, Cindy Jardine, Tania M. Bubela

Office of the Provost

Objectives: Effective communication by public health agencies during a pandemic promotes the adoption of recommended health behaviours. However, more information is not always the solution. Rather, attention must be paid to how information is communicated. Our study examines the television news, which combines video and audio content. We analyse (1) the content of television news about the H1N1 pandemic and vaccination campaign in Alberta, Canada; (2) the extent to which television news content conveyed key public health agency messages; (3) the extent of discrepancies in audio versus visual content.
Methods: We searched for "swine flu" and "H1N1" in local English …

Quantitative Evaluation Of Antibiotic Exposure-Response Relationships Among Patients With Serious Staphylococcal Infections, Thomas Patrick Lodise

Legacy Theses & Dissertations (2009 - 2024)

This dissertation advances our understanding of antimicrobial exposure-response relationships among patients with serious infections due to Staphylococcus aureus. The need is pressing as treatment of this invasive pathogen has been complicated by the development of antibiotic resistance. One antibiotic resistant phenotype of particular concern is methicillin-resistant S. aureus (MRSA). Due to the multi-drug resistant nature of most MRSA strains, vancomycin emerged as the cornerstone of therapy. Although widely used for serious MRSA infections, many clinicians now question its continued utility due to the emergence of MRSA strains with reduced vancomycin susceptibility phenotypes (rVSPs). The literature is developing rapidly, but characterization …

The Effectiveness Of Health Education Materials In Influencing Hiv Testing Behavior: The Unlv-Siphi Study, Rebecca Tsegay

UNLV Theses, Dissertations, Professional Papers, and Capstones

The UNLV-SIPHI (Sexual Health Internet-Based Public Health Intervention) Study focused on HIV prevention by improving HIV testing behavior through the development and dissemination of health education materials. The goal of the UNLV-SIPHI Study was to develop effective, custom-made HIV health education materials that promote the knowledge, intention and practice of HIV testing among UNLV students. The UNLV-SIPHI Study was conducted during Spring 2012 semester in selected UNLV undergraduate classes. An online quasi-randomized-control trial (RCT) was used to measure the difference in HIV testing behavior contributing factors among students exposed to the health education materials. Several nonparametric tests were used to …

Using Box-Jenkins Modeling Techniques To Forecast Future Disease Burden And Identify Disease Aberrations In Public Health Surveillance Report, Larry C. Garrett

Dissertations

The analysis of public health surveillance data to identify departures from historical patterns of disease is required to facilitate the timely identification of potential outbreaks. Using the Box-Jenkins forecasting model, this study examines the potential to predict future disease burden based upon the historical record within local public health jurisdictions. Box-Jenkins forecasting was developed as a direct result of forecast problems in the business, economic, and control-engineering applications, yet it has not been systematically examined for use with public heath surveillance data.

Box-Jenkins forecast models are constructed by stratifying 84,029 disease reports from the State of Utah by year (n …

Epidemiology Of Tuberculosis In Ohio, Usha Bala Vayuvegula

Master of Public Health Program Student Publications

Background: Tuberculosis (TB) is a global infectious disease often associated with HIV. Study of the distribution and epidemiologic trends may help target prevention and control measures towards high risk areas and groups.

Objective: To determine TB trends in four counties in Ohio, i.e. Franklin, Cuyahoga, Hamilton and Montgomery counties, and to explore differences in distribution of cases across gender, age groups and races.

Methods: TB surveillance data was collected from the Ohio Department of Health website for 12 years (1999-2011). Mean TB rates across gender were compared using the two sample t-test. One way ANOVA was used to compare means …

Measuring Infertility In Populations: Constructing A Standard Definition For Use With Demographic And Reproductive Health Surveys, Maya N. Mascarenhas, Hoiwan Cheung, Colin D. Mathers, Gretchen A. Stevens

Dartmouth Scholarship

Background: Infertility is a significant disability, yet there are no reliable estimates of its global prevalence. Studies on infertility prevalence define the condition inconsistently, rendering the comparison of studies or quantitative summaries of the literature difficult. This study analyzed key components of infertility to develop a definition that can be consistently applied to globally available household survey data.

Methods: We proposed a standard definition of infertility and used it to generate prevalence estimates using 53 Demographic and Health Surveys (DHS). The analysis was restricted to the subset of DHS that contained detailed fertility information collected through the reproductive health calendar. …

Refining The Global Spatial Limits Of Dengue Virus Transmission By Evidence-Based Consensus, Oliver J. Brady, Peter W. Gething, Samir Bhatt, Jane P. Messina, John S. Brownstein, Anne G. Hoen

Dartmouth Scholarship

Background: Dengue is a growing problem both in its geographical spread and in its intensity, and yet current global distribution remains highly uncertain. Challenges in diagnosis and diagnostic methods as well as highly variable national health systems mean no single data source can reliably estimate the distribution of this disease. As such, there is a lack of agreement on national dengue status among international health organisations. Here we bring together all available information on dengue occurrence using a novel approach to produce an evidence consensus map of the disease range that highlights nations with an uncertain dengue status.

Methods/Principle Findings: …

A Geographical Analysis Of Hiv/Aids Infection In Nigeria, 1991-2001, Chinekwu Azuka Obidoa, Robert G. Cromley

Journal of Social, Behavioral, and Health Sciences

Abstract

Objectives: Within the gradually accumulating literature on the Acquired Immune Deficiency Syndrome (AIDS) in Nigeria, investigations concerning the spatial dimensions of the infection are virtually non-existent. An understanding of the spatial dimensions of the epidemic is central in the development and implementation of appropriate intervention strategies. This study is a geographic analysis of HIV/AIDS infection in Nigeria from 1991 – 2001. The three objectives of this study were: 1) to examine the geographic pattern of the epidemic, 2) to examine the spatial-temporal trend and diffusion pattern of the epidemic, and 3) to explore the factors associated with the spatial …

Two Boundaries Separate Borrelia Burgdorferi Populations In North America, Gabriele Margos, Jean I. Tsao, Santiago Castillo-Ramirez, Yvette A. Girard, Anne G. Hoen

Dartmouth Scholarship

Understanding the spread of infectious diseases is crucial for implementing effective control measures. For this, it is important to obtain information on the contemporary population structure of a disease agent and to infer the evolutionary processes that may have shaped it. Here, we investigate on a continental scale the population structure of Borrelia burgdorferi, the causative agent of Lyme borreliosis (LB), a tick-borne disease, in North America. We test the hypothesis that the observed d population structure is congruent with recent population expansions and that these were preceded by bottlenecks mostly likely caused by the near extirpation in the 1900s …

A Mathematical Model For Dengue Fever In A Virgin Environment, Jason K. Bowman

Senior Honors Projects

Dengue is a mosquito-borne viral infection found in tropical and subtropical regions around the world. The disease was named in 1779 and the first recorded epidemic of it occurred simultaneously on three continents within the following decade. Dengue is characterized by flu-like symptoms and, while its symptoms are generally reported as quite unpleasant, is rarely fatal. However, in some cases patients can contract a more serious form of the disease, known as Dengue Hemorrhagic Fever, which is far more dangerous. The World Health Organization estimates that today over 2.5 billion people are at risk for Dengue (over 40% of the …

Tropical Medicine Training In The Department Of Defense, Rodney L. Coldren, David Brett-Major, Patrick W. Hickey, Eric Garges, Peter J. Weina, Paula Corrigan, Gerald Quinnan

Journal Articles: Epidemiology

No abstract provided.

Analysis Of The Morbidity And Mortality Of Severe Influenza Infection In Clark County, Nevada For The 2010--2011 Influenza Season, Kindra Maureen St. Jacques

UNLV Theses, Dissertations, Professional Papers, and Capstones

Influenza circulates in the community in a fairly predictable manner each year; however, throughout the duration of any influenza season, influenza strains have the ability to evolve through antigenic mutations, viral reassortment, development of anti-viral resistance, and alterations in virulence. These changes are likely to cause illness among the unimmunized and can result in severe illness or death. Therefore, it is especially important to closely monitor severe influenza-associated hospitalizations and deaths. The University of Nevada, Las Vegas in collaboration with the Southern Nevada Health District (SNHD), Office of Epidemiology (OOE) analyzed data from the severe hospitalized influenza morbidity and mortality …

Characterization Of Street Food Consumption In Palermo: Possible Effects On Health, Silvio Buscemi, Annamaria Barile, Vincenza Maniaci, John A. Batsis

Dartmouth Scholarship

Background: Street Food (SF) consists of out-of-home food consumption and has old, historical roots with complex social-economic and cultural implications. Despite the emergence of modern fast food, traditional SF persists worldwide, but the relationship of SF consumption with overall health, well-being, and obesity is unknown.

Methods: This is an observational, cross-sectional study. The study was performed in Palermo, the largest town of Sicily, Italy. Two groups were identified: consumers of SF (n = 687) and conventional restaurant food (RES) consumers (n = 315). Study subjects answered a questionnaire concerning their health conditions, nutritional preferences, frequency of consumption of SF and …

Heterogeneity, Control, Social Infrastructure, And Possibilities Of Participation: Their Interplay In Modern Understandings Of Heredity And In Interpretation Of Science, Peter J. Taylor

Working Papers on Science in a Changing World

This working paper is a prospectus for research, writing, and engagement. It consists of vignettes, sketches of lines of inquiry, and proposals for engagement, all of which concern modern understandings of heredity and development over the life course as well as the social interpretation of science. The various items address a range of areas of science and of its interpretation: heritability studies, the social uses of genetic information, gene-by-environment interaction, personalized medicine, IQ paradoxes, racial group membership, biobanks, and life events and difficulties research. Fresh perspectives in these areas are opened up by examining the ways that research and application …

Modeling Mortality Rates For Leukemia Between Men And Women In The United States, Blessed Quansah

UNLV Theses, Dissertations, Professional Papers, and Capstones

Leukemia related deaths increased dramatically over the last forty years. Leukemia is a malignant disease or cancer of the bone marrow and blood. It is characterized by the uncontrolled accumulation of blood cells. Leukemia is divided into two categories: myelogenous or lymphocytic, each of which can be acute or chronic. The terms, myelogenous or lymphocytic denote the cell type involved.

In this thesis, the proposed modeling techniques are applied to leukemia deaths data from the Surveillance Epidemiology and End Results (SEER). In particular, annual deaths data from 1969 to 2007 are used in the data analysis, which includes three major …

Kriged And Modeled Ambient Air Levels Of Benzene In An Urban Environment: An Exposure Assessment Study, Kristina W. Whitworth, Elaine Symanski, Dejian Lai, Ann L. Coker

CRVAW Faculty Journal Articles

Background. There is increasing concern regarding the potential adverse health effects of air pollution, particularly hazardous air pollutants (HAPs). However, quantifying exposure to these pollutants is problematic. Objective. Our goal was to explore the utility of kriging, a spatial interpolation method, for exposure assessment in epidemiologic studies of HAPs. We used benzene as an example and compared census tract-level kriged predictions to estimates obtained from the 1999 U.S. EPA National Air Toxics Assessment (NATA), Assessment System for Population Exposure Nationwide (ASPEN) model. Methods. Kriged predictions were generated for 649 census tracts in Harris County, Texas using estimates of annual benzene …