Epidemiology Commons^™

Demographic, Environmental, And Clinical Variables Associated With Dengue In Saint Lucia, Brendan Lee

Walden Dissertations and Doctoral Studies

Dengue is the most important arboviral disease of public health concern on the world stage. In Saint Lucia, the disease has been endemic for years. Little research has been published on the specific epidemiology of dengue in Saint Lucia, and this study sought to identify the risk factors associated with the disease specific to the island. This study was underpinned by ecological theory, which is used to explain the possible relationships between risk factors and the occurrence of dengue. This three-manuscript study was used to evaluate the relationship between demographic, environmental, and clinical variables and the occurrence of dengue as …

Accuracy Of Death Certificate Data In Reporting Suicide In The United States, Miland Ned Palmer

Walden Dissertations and Doctoral Studies

Suicide is one of the leading causes of death in the United States. Death certificates are currently being used by public health professionals and policy makers as a main source of public health surveillance data on suicide. The accuracy of death certificates in tracking and reporting suicides has not been well quantified or evaluated in the United States. Death certificates from other countries have been found to under-report suicide. The purpose of this study was to evaluate the accuracy of death certificates in reporting suicides in the United States. The National Violence Death Reporting System (NVDRS) collects information on all …

Demographics, Naloxone Accessibility, And Repeat Opioid Overdose In The United States, Craig Hamp Booker

Walden Dissertations and Doctoral Studies

Approximately 2.1 million people in the United States suffer from opioid use disorder, and over 47,600 people die from opioid-related overdoses each year. Opioid overdose is often treated with naloxone, a quick-acting medication that counteracts the effects of an overdose. This quantitative, correlational study was conducted to determine whether demographics (gender, age, and race) and naloxone accessibility were predictors of repeat opioid overdose in a Tennessee county in the United States. The study was developed and conducted using principles of the diffusion of innovations theory. Descriptive and inferential analyses were conducted using secondary, county-level data (n = 967) from emergency …

Family Rejection And Unprotected Sex Inlatino Gay Men, Juan Alejandro De Llano Montano

Walden Dissertations and Doctoral Studies

The present work explored the role of family rejection on the sexual behavior of Latino gay men under the guidance of the minority stress model. Family rejection was analyzed as a distal stressor, self-esteem as a proximal stressor, and unprotected sex as the outcome. The hypotheses were tested using regression, mediation, and multiple regression of secondary data from the Latino men who have sex with men (MSM) community involvement project. The results suggested that family rejection is a weak predictor of low self-esteem and engaging in receptive unprotected sex with more partners. Low self-esteem did not mediate the relationship between …

Neighborhood Factors, Depression, And Body Mass Index Among Patients With Lupus In Georgia, Aisha L. Hill

Walden Dissertations and Doctoral Studies

Elevated BMI (overweight and obesity) is a common health-related issue and affects more than half of the lupus population. Weight issues lead to additional health-related issues, such as heart disease and disabilities in the lupus population. To address the shortage of research focusing on this specific issue in the lupus population, one approach is a novel outlook on how neighborhood factors have the capability of determining or altering behaviors, such as physical activity, healthy eating, and healthy social relationships. Another variable to consider is depression and its capability of altering interactions, relationships, self-esteem, or even the inflammatory state of the …

Rickettsialpox – A Rare But Not Extinct Disease: A Review Of The Literature And New Directions, Marina Eremeeva, Kamalich Muniz-Rodriguez

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Smallpox rickettsia is an urban zoonosis caused by Rickettsia akari. To date, R. akari is the only characterized representative of the group of spotted fevers transmitted by the gamasid mite Liponyssoides sanguineus, which is common among peridomic rodents. This disease was first described in New York in 1946, and a few years later a similar outbreak occurred in the Ukrainian SSR. Numerous serological studies and diagnostics of sporadic cases of smallpox rickettsiosis suggest its widespread occurrence on the planet; however, the current geography and incidence of smallpox rickettsiosis is unknown. Smallpox rickettsiosis is characterized by the classic clinical triad of …

Covid-19: A Simple Curve Approximation Tool, Jane Courtney

Articles

In the current COVID-19 pandemic, much focus is put on ‘flattening the curve’. This ‘curve’ refers to the cases versus time graph, which shows the rise of a disease to its peak before descending. The aim in a pandemic is to flatten this curve by reducing the peak and spreading out the timeline. However, the models used to predict this curve are often not clearly outlined, no model parameters are given, and models are not tested against real data. This lack of detail makes it difficult to recreate the curve from these models. What is much needed is a simple …

The Cholera Crisis In Yemen: Case Studies On Vulnerability And Resilience In Sana'a, Al Hudaydah, And Ma'areb, Noor Albannein A. Al-Saad

Honors Theses and Capstones

The largest recorded cholera epidemic in history is happening right now in Yemen, a country which has reported over 2 million cases of cholera as of 2020. Yemen has a history of endemic cholera, but prolonged conflict in the country has led to deteriorating conditions that have triggered massive outbreaks of the disease. The purpose of this study is to investigate the direct and indirect causes of the cholera epidemic in Yemen by proposing factors that may confer vulnerability and resilience in Yemeni governorates. Case studies were constructed for three governorates: Sana’a and the inner municipality of Amanat Al Asimah; …

Rethinking Global Governance To Address Zoonotic Disease Risks: Connecting The Dots, Kelley Lee

Animal Sentience

Large-scale changes in human behaviour are urgently needed to prevent future pandemics involving zoonotic diseases such as COVID-19. However, this will not happen to the required degree, and with sufficient speed, without a major shift in how humanity collectively governs itself. Alongside a shift in focus from individual behaviours to the structural conditions underpinning the world economy that shape human behaviours, effective global governance presses us to connect more dots than ever before. The One Health approach is an important starting point but we need to go much further.

Covid-19 And The Conundrum Of Mask Requirements, Robert Gatter, Seema Mohapatra

All Faculty Scholarship

As states begin to loosen their COVID-19 restrictions, public debate is underway about what public health measures are appropriate. Many states have some form of mask-wearing orders to prevent the spread of COVID-19 infection. Public health guidance from the Centers for Disease Control and Prevention and the World Health Organization has conflicted. From a public health point of view, it is not clear what the right answer is. In the absence of directives, individuals are also making their own choices about mask use. At a time when public health measures, like shelter-in-place orders and social distancing, are being used to …

Risks For Hiv Infection Among Adolescent Girls And Young Women In Mozambique, Isabelle Casavant

Walden Dissertations and Doctoral Studies

Adolescent girls and young women (AGYW) living in Sub-Saharan African countries constitute 17% of the population, yet they account for one third of all new human immunodeficiency virus (HIV) infections. To prevent HIV infections among AGYW, it is necessary to understand why they are disproportionally infected. The purpose of the dissertation was to identify risk for HIV among AGYW living in a southern district of Mozambique. The analysis was driven by the Modified Socio Ecological Model and performed using a quantitative dataset collected for the Chokwe Combination Prevention of HIV (N=3354). Logistic regression analysis was conducted to assess whether an …

Predictors Of The Health Effects Of Marijuana Use On The Hepatic Function, Makafui Kokou Gbogbo

Walden Dissertations and Doctoral Studies

The quantity of marijuana use, the length of time it was used, and the age of initiation of the drug are at the core of the discussions about the potential health effects of marijuana use on the liver. Results of recent studies regarding how the drug affects human health have resulted in a number of conflicting conclusions. Nevertheless, based on these findings, marijuana users are being denied liver transplants. The objective of this study was to identify predictors of the health effects of marijuana on the liver and provide guidance in the care management of marijuana users. To address the …

The Association Between Central Line Insertion Practices And Central Line-Associated Bloodstream Infections, Mona Elgowainy

Walden Dissertations and Doctoral Studies

Healthcare-associated infections, specifically central line-associated bloodstream infections (CLABSI), continue to remain a serious public health concern in the United States. Though CLABSI can often be prevented, healthcare professionals struggle to have a positive impact on CLABSI rates. The primary purpose of this study was to determine whether CLIP Bundle adherence has an impact on CLABSI standardized infection ratio (SIR) rates in various patient care areas in California. The research questions were focused on assessing whether there was an association between patient care areas, CLABSI rates, and CLIP Bundle adherence scores. A quantitative, cross-sectional study design utilizing secondary data was used …

Factors Associated With Flu Vaccination Status Among Older Hispanics In The United States, William Esteban Toledo Velazquez

Walden Dissertations and Doctoral Studies

AbstractOlder Hispanics in the United States are less likely to be vaccinated with the flu vaccine compared to older White Americans, despite being at higher risk of influenza-associated deaths and hospitalizations. A quantitative cross-sectional study based on the social ecological model was carried out to evaluate the influence of several sociodemographic and health factors on flu vaccination status among elderly Hispanic individuals in the United States. Logistic regression analyses were conducted using secondary data collected from 95,414 elderly Hispanic and White American 2018 Behavioral Risk Factor Surveillance System participants. Multivariate logistic regressions controlling for other variables revealed health care coverage …

The Relationship Between Cervical Cancer And Women Living With Disabilities In Kentucky, Carolyn Akakpo

Walden Dissertations and Doctoral Studies

AbstractDespite many national interventions, cervical cancer (CC) rates persist, and in Kentucky (KY), CC incidence rates are on the rise. Additionally, women with disabilities face more barriers to secondary prevention and healthcare access, have more known risks, and experience more health disparities than women without disabilities. Given that 1 in 4 persons live with a disability, the purpose of this observational, cross-sectional, quantitative study was to explore the relationship between CC and women with disabilities as evidenced by reproductive cancer discharges from inpatient hospital (IHD) and outpatient services databases (OSD) so as to compare population-specific differences from social determinants of …

Risk Factors For Polysubstance Abuse: A National Secondary Data Analysis Study, Dakota Mcmurray

Walden Dissertations and Doctoral Studies

Substance abuse is a serious public health problem in the United States and globally. Abuse of more than one substance is considered polysubstance abuse and can cause more harm than abuse of only one substance. Polysubstance abuse compounds the problems of addiction because of the variety of substances that may be used and the resulting side effects. This quantitative cross-sectional secondary data analysis, guided by the socio-ecological theory, assessed patient characteristics and how predictive they were for polysubstance abuse. The study sample of 986 patients was analyzed by binomial logistic regression to assess the association between patient-related factors and polysubstance …

Access To Healthcare For American Indians Residing In The Northeast United States, Kristine D. Thomas-Jones

Walden Dissertations and Doctoral Studies

Urban American Indians/Alaskan Natives (AIs/ANs) have limited access to health care in comparison to non-Hispanic Whites (NHWs), which furthers health disparities for indigenous communities. The purpose of this quantitative, nonexperimental study, which was guided by the socioecological model, was to examine the relationship between access to health care and healthcare utilization among urban AIs/ANs and urban NHWs in the Northeast United States. The research questions addressed the difference in access to healthcare based on health insurance, difference in healthcare utilization, and whether there is an association between health care access and health care utilization for AIs in the Northeast United …

Prostate Cancer Screening Intention Among African American Males Ages 40 To 65 Years, Paul L. Johnson

Walden Dissertations and Doctoral Studies

African American men are at a higher risk of developing and dying from prostate cancer (PCa) compared with any other race or ethnic group. Despite prostate cancer screening (PCS) recommendations, African American men are less likely to be screened for PCa compared with any other race or ethnic group. The purpose of this study was to identify factors that influence the intentions of African American men to obtain a PCS. A nonexperimental cross-sectional research design was used to identify factors associated with the intention to obtain PCS. The theoretical framework for the study was the social-ecological model which posits that …

Hiv Prevention: Pre-Exposure Prophylaxis, Sexual Decision Making, Risk Taking, And Condoms, Jonathan D. Spencer

Walden Dissertations and Doctoral Studies

HIV is an infectious disease that continues to have new cases each year within high-risk populations, such as men who have sex with men (MSM). To help in the fight against new HIV infections within the MSM population, new medications such as pre-exposure prophylaxis (PrEP) are being used. The purpose of this cross-sectional online survey study was to address whether PrEP use had any relationship with (a) sexual decision-making, (b) risk-taking, and (c) condom use in the MSM population 18-64 years of age, after controlling for socioeconomic status, race, and age while using the behavioral disinhibition and risk compensation models. …

Contemporary Epidemiology Of Rising Atrial Septal Defect Trends Across Usa 1991–2016: A Combined Ecological Geospatiotemporal And Causal Inferential Study, Albert Stuart Reece, Gary Kenneth Hulse

Research outputs 2014 to 2021

© 2020, The Author(s). Background: Cardiovascular anomalies are the largest group of congenital anomalies and the major cause of death in young children, with various data linking rising atrial septal defect incidence (ASDI) with prenatal cannabis exposure. Objectives / Hypotheses. Is cannabis associated with ASDI in USA? Is this relationship causal? Methods: Geospatiotemporal cohort study, 1991–2016. Census populations of adults, babies, congenital anomalies, income and ethnicity. Drug exposure data on cigarettes, alcohol abuse, past month cannabis use, analgesia abuse and cocaine taken from National Survey of Drug Use and Health (78.9% response rate). Cannabinoid concentrations from Drug Enforcement Agency. Inverse …

Motor Vehicle Fatalities During Memorial Day Weekends, 1981-2016, Yuni Tang, Kendra Ratnapradipa, Henry Xiang, Motao Zhu

Journal Articles: Epidemiology

OBJECTIVE: Motor vehicle crashes are a leading cause of injury death in the United States, and Memorial Day weekend is one of six holiday periods with an increased number of motor vehicle fatalities in the United States. However, few motor vehicle fatality comparisons were made between Memorial Day weekend and non-holiday periods. Our aims were to determine which day(s) during the holiday had highest motor vehicle fatality risk compared to non-holiday travel and to identify potential risk factors.

RESULTS: Of 43,457 traffic fatalities studied, 15,292 (35%) occurred during the holiday, with Saturday being deadliest but Monday having highest odds of …

Deployment And Travel Medicine Knowledge, Attitudes, Practices, And Outcomes Study (Kapos): Malaria Chemoprophylaxis Prescription Patterns In The Military Health System, Patrick W. Hickey, Indrani Mitra, Jamie Fraser, David Brett-Major, Mark S. Riddle, David R. Tribble

Journal Articles: Epidemiology

The Deployment and Travel Medicine Knowledge, Attitudes, Practices, and Outcomes Study (KAPOS) examines the integrated relationship between provider and patient inputs and health outcomes associated with travel and deployments. This study describes malaria chemoprophylaxis prescribing patterns by medical providers within the U.S. Department of Defense's Military Health System and its network of civilian healthcare providers during a 5-year period. Chemoprophylaxis varied by practice setting, beneficiary status, and providers' travel medicine expertise. Whereas both civilian and military facilities prescribe an increasing proportion of atovaquone-proguanil, doxycycline remains the most prevalent antimalarial at military facility based practices. Civilian providers dispense higher rates of …

Aerosol And Surface Contamination Of Sars-Cov-2 Observed In Quarantine And Isolation Care, Joshua L. Santarpia, Danielle N. Rivera, Vicki L. Herrera, M. Jane Morwitzer, Hannah M. Creager, George W. Santarpia, Kevin K. Crown, David Brett-Major, Elizabeth R. Schnaubelt, M. Jana Broadhurst, James V. Lawler, St. Patrick Reid, John Lowe

Journal Articles: Epidemiology

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originated in Wuhan, China in late 2019, and its resulting coronavirus disease, COVID-19, was declared a pandemic by the World Health Organization on March 11, 2020. The rapid global spread of COVID-19 represents perhaps the most significant public health emergency in a century. As the pandemic progressed, a continued paucity of evidence on routes of SARS-CoV-2 transmission has resulted in shifting infection prevention and control guidelines between classically-defined airborne and droplet precautions. During the initial isolation of 13 individuals with COVID-19 at the University of Nebraska Medical Center, we collected air …

Mitigating A Covid-19 Outbreak Among Major League Baseball Players - United States, 2020, Meghan T. Murray, Margaret A. Riggs, David M. Engelthaler, Caroline Johnson, Sharon Watkins, Allison Longenberger, David Brett-Major, John Lowe, M. Jana Broadhurst, Chandresh N. Ladva, Julie M. Villanueva, Adam Macneil, Shoukat Qari, Hannah L. Kirking, Michael Cherry, Ali S. Khan

Journal Articles: Epidemiology

Mass gatherings have been implicated in higher rates of transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), and many sporting events have been restricted or canceled to limit disease spread (1). Based on current CDC COVID-19 mitigation recommendations related to events and gatherings (2), Major League Baseball (MLB) developed new health and safety protocols before the July 24 start of the 2020 season. In addition, MLB made the decision that games would be played without spectators. Before a three-game series between teams A and B, the Philadelphia Department of Public Health was notified of a team A …

Hepatitis B Seroprevalence In The U.S. Military And Its Impact On Potential Screening Strategies, Paul T. Scott, Robert L. Cohen, David Brett-Major, Shilpa Hakre, Jennifer A. Malia, Jason F. Okulicz, Charmagne G. Beckett, Jason M. Blaylock, Michael A. Forgione, Stephen A. Harrison, Clinton K. Murray, Francisco J. Rentas, Roland L. Fahie, Adam W. Armstrong, Aatif M. Hayat, Laura A. Pacha, Peter Dawson, Beth Blackwell, Angelia A. Eick-Cost, Hala H. Maktabi, Nelson L. Michael, Linda L. Jagodzinski, Steven B. Cersovsky, Sheila A. Peel

Journal Articles: Epidemiology

INTRODUCTION: Knowledge of the contemporary epidemiology of hepatitis B virus (HBV) infection among military personnel can inform potential Department of Defense (DoD) screening policy and infection and disease control strategies.

MATERIALS AND METHODS: HBV infection status at accession and following deployment was determined by evaluating reposed serum from 10,000 service members recently deployed to combat operations in Iraq and Afghanistan in the period from 2007 to 2010. A cost model was developed from the perspective of the Department of Defense for a program to integrate HBV infection screening of applicants for military service into the existing screening program of screening …

The Impact Of Body Mass Index And Sociodemographic Factors On Moderate-To-Vigorous Physical Activity And Sedentary Behaviors Of Women With Young Children: A Cross-Sectional Examination, Danae M. Dinkel, Nicholas Hein, Kailey Snyder, Mohammad Siahpush, Shannon I. Maloney, Lynette M. Smith, Evi A. Farazi, Corrine K. Hanson

Journal Articles: Epidemiology

OBJECTIVES: Moderate-to-vigorous physical activity provides multiple benefits to women after childbirth. To achieve these benefits, the recommendation that adults obtain, 150 min of moderate-to-vigorous physical activity per week and reduce sedentary behaviors, also applies to women in the post-partum phase of the life span. However, research examining the moderate-to-vigorous physical activity and sedentary behaviors of women with young children (0-2 years) is limited. A greater understanding of these behaviors from a nationally representative sample is needed. Therefore, the primary objective of this study was to determine the levels of moderate-to-vigorous physical activity and sedentary behaviors of a nationally representative sample …

Thirty-Day Unplanned Readmission And Its Effect On 90-Day Mortality In Hepatocellular Carcinoma Patients Undergoing Partial Hepatectomy, Yongyue Qi, Tricia Levan, Gleb Haynatzki, Chandrakanth Are, Evi A. Farazi

Journal Articles: Epidemiology

Background: Despite advances of surgical techniques, hepatectomy continues to be potentially dangerous and is associated with postoperative mortality, morbidity and readmission. The objective of this study was to determine the effect of 30-day unplanned readmission on ‘conditional’ 90-day mortality among hepatocellular carcinoma (HCC) patients who underwent partial hepatectomy.

Methods: National Cancer Database (NCDB) was queried from 2004 to 2012 for patients with hepatocellular carcinoma (HCC) who underwent partial hepatectomy. Thirty-day unplanned readmission rate, and associated risk factors, was determined for 7,696 patients. The association between 30-day unplanned readmission and conditional 90-day mortality was further addressed.

Results: The 30-day unplanned readmission …

Acute Encephalopathy With Elevated Csf Inflammatory Markers As The Initial Presentation Of Covid-19, Shelli Farhadian, Laura R. Glick, Chantal B. F. Vogels, Jared Thomas, Jennifer Chiarella, Arnau Casanovas-Massana, Jing Zhou, Camila Odio, Pavithra Vijayakumar, Bertie Geng, John Fournier, Santos Bermejo, Joseph R. Fauver, Tara Alpert, Anne L. Wyllie, Cynthia Turcotte, Matthew Steinle, Patrick Paczkowski, Charles Dela Cruz, Craig Wilen, Albert I. Ko, Sean Mackay, Nathan D. Grubaugh, Serena Spudich, Lydia Aoun Barakat

Journal Articles: Epidemiology

BACKGROUND: COVID-19 is caused by the severe acute respiratory syndrome virus SARS-CoV-2. It is widely recognized as a respiratory pathogen, but neurologic complications can be the presenting manifestation in a subset of infected patients.

CASE PRESENTATION: We describe a 78-year old immunocompromised woman who presented with altered mental status after witnessed seizure-like activity at home. She was found to have SARS-CoV-2 infection and associated neuroinflammation. In this case, we undertake the first detailed analysis of cerebrospinal fluid (CSF) cytokines during COVID-19 infection and find a unique pattern of inflammation in CSF, but no evidence of viral neuroinvasion.

CONCLUSION: Our findings …

Reduction Of Polyunsaturated Fatty Acids With Tumor Progression In A Lean Non-Alcoholic Steatohepatitis-Associated Hepatocellular Carcinoma Mouse Model, Elizabeth M. Vlock, Shilpa Karanjit, G. Talmon, Evi A. Farazi

Journal Articles: Epidemiology

Background and Aim: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries. While obesity and diabetes are the hallmarks of NAFLD, it also develops in lean individuals in the absence of metabolic syndrome, with a prevalence of 7 percent in the U.S. and 25-30 percent in some Asian countries. NAFLD represents the spectrum of liver disease, starting with excess liver fat accumulation (NAFL) that can progress to nonalcoholic steatohepatitis (NASH), cirrhosis and ultimately hepatocellular carcinoma (HCC). To date, the pathogenesis of lean NASH-HCC is poorly understood and a mouse model is lacking. We aimed …

Parasitic Infections Represent A Significant Health Threat Among Recent Immigrants In Chicago, Jesica A. Herrick, Monica Nordstrom, Patrick M. Maloney, Miguel Rodriguez, Kevin Naceanceno, Gloria Gallo, Rojelio Mejia, Ron Hershow

Journal Articles: Epidemiology

Parasitic infections are likely under-recognized among immigrant populations in the USA. We conducted a cross-sectional study to evaluate if such infections have health impacts among recent immigrants in Chicago and to identify predictive factors for parasitic infections. A total of 133 recent immigrants were enrolled, filling out a standardized medical questionnaire and providing blood and stool samples. Appriximately 12% of subjects (15/125) who provided a blood or stool sample for testing were found to have evidence of current or prior infection with a pathogenic parasite, of which Toxocara spp. (8 subjects, 6.4%) and Strongyloides stercoralis (5 subjects, 4%) were most …