Epidemiology Commons^™

The Association Between Teen Parenthood And Marital Status Among Women, Amy Feinberg

Theses and Dissertations

Introduction: Teen pregnancy and teen parenting are prevalent and significant public health issues. Teen parenting also has many social and economic consequences for mother and family. Single parenthood is associated with increased financial, work and child care strains compared to a more traditional family type. Therefore, the impact of teen pregnancy on marital status needs to be investigated. This study examines the association between teen parenthood and future marital status. Methods: The 2002 National Survey of Family Growth, Cycle 6 was analyzed. This study included 12398 women age 20 – 44 years who had children. Teen parenthood was defined as …

A Community-Engaged Research Approach To The Development Of An Assessment Tool For Historical Data Collection Of Saara Client Population, Jessica Markey

Theses and Dissertations

Through collaboration between the Substance Abuse and Addiction Recovery Alliance (SAARA) and several community partners, a need was identified for a new measurement tool to gather comprehensive client histories for program evaluation and development. The purpose of this study was to (1) develop a culturally relevant and organizationally appropriate mechanism for the collection of comprehensive client histories and (2) to provide the opportunity for staff to engage in a new process of developing and implementing data collection strategies. As a result of the use of a community-based participatory approach, (1) a missed opportunity for program evaluation and development was identified, …

A Qualitative Approach To Explore The Experiences Of Health Care Providers Who Treat Patients For Post Traumatic Stress Disorder (Ptsd), Mark Killebrew

Theses and Dissertations

Post Traumatic Stress Disorder (PTSD) is an anxiety disorder that occurs when people are exposed to stressful, life-threatening experiences. Consequently, after exposure to such an event, many people may experience fear, guilt, or anger and may believe the trauma is reoccurring. According to the National Institute of Mental Health, approximately 5.2 million U.S. adults age 18-54 have PTSD in any given year. The prevalence of PTSD is even more problematic within the military where an estimated 30% of those who have spent time in war zones experiences PTSD. Researchers have been examining the impact of veterans’ PTSD symptoms on family …

Statin Use And The Risk Of Clostridium Difficile In Academic Medical Centers: A Matched Case Control Study, Christine Motzkus

Theses and Dissertations

BACKGROUND: Increasing rates of hospital acquired Clostridium difficile (CDI), as well as mortality owing to CDI, warrants further exploration of risk factors. Clostridium difficile bacteria typically produce toxins which inactivate the Rho proteins found in the colonic epithelium. Statins also disrupt Rho protein cell signaling functions. The objective of this study was to estimate the extent to which use of statins increases the risk of healthcare-acquired CDI. METHODS: Patients over 18 years of age admitted to hospitals contributing data to the University HealthSystem Consortium between 2002 and 2009 were eligible. We identified 25, 111 incident cases of CDI and matched …

The Relationship Between Treatment-Seeking And Characteristics Of Depression Among African Americans, Tamara Scott

Theses and Dissertations

Objective: Depression is a common psychiatric condition, and despite the availability of effective treatments, this condition is largely under-recognized and undertreated, particularly among African Americans. One reason for this discrepancy may be that depressive symptoms often co-occur with physical health conditions, which can influence both the reporting of depressive symptomology, willingness to seek care, and the type of healthcare provider sought. The purpose of this study was to explore the relationship between treatment-seeking characteristics and diagnostic attributions of depression among community-dwelling African American adults. Methods: Data come from the National Survey of American Life, a nationally representative sample of African …

Strategies For Deriving A Single Measure Of The Overall Burden Of Antimicrobial Resistance In Hospitals, Alessandro Orlando

Theses and Dissertations

Background: Antimicrobial-resistant infections result in hospital stays costing between $18,000 and $29,000. As of 2009, Centers for Medicare and Medicaid Services no longer upgrade payments for hospital-acquired infections. Hospital epidemiologists monitor and document rates of individual resistant microbes in antibiogram reports. Overall summary measures capturing resistance within a hospital may be useful. Objectives: We applied four techniques (L1- and L2-principal component analysis (PCA), desirability functions, and simple summary) to create summary measures of resistance and described the four summary measures with respect to reliability, proportion of variance explained, and clinical utility. Methods: We requested antibiograms from hospitals participating in the …

The Effect Of Medicaid Policy Reform On Dental Utilization Rates For Children, Matthew Winheim

Theses and Dissertations

Background: Regular access to dental services is a well-known factor in the oral health and development of children.1 As such, the United States federal government mandates each state to include dental services for children enrolled in Medicaid through the age of 21. Despite this mandate, the utilization rate of dental services among Medicaid enrolled children has remained remarkably low.2 In July 2005, Virginia implemented a sweeping Medicaid policy reform titled “Smiles for Children,” specifically aiming to increase Medicaid pediatric dental utilization rates. The purpose of this study aims to assess the effect of this 2005 policy reform on the utilization …

The Association Between Prenatal Care Content And Quality With Preterm Birth And Maternal Postpartum Health Behaviors, Susan Cha

Theses and Dissertations

Background: Health policies that seek to improve pregnancy outcomes focus on increasing the availability and access to prenatal care (PNC) services based on studies that support an association between insufficient PNC and adverse birth outcomes. These studies employ PNC utilization indices that measure the adequacy of PNC use, but these indices fail to account for the content or specific components of PNC. Objectives: The purpose of this study was to utilize PRAMS and birth certificate data to evaluate the content and quality of PNC in Virginia, and its impact on preterm birth and maternal postpartum health behaviors. Methods: Data was …

Nonmedical Prescription Drug Use On College Campuses: Risk Factors For Abuse, Jennifer Barber

Theses and Dissertations

Background: In recent years, there has been an increase in prescription drug abuse, particularly among adolescents and young adults. While substance abuse on college campuses has remained a pervasive public health concern, rates of nonmedical prescription drug use surpass commonly abused drugs. The three most commonly abused prescription drugs (central nervous system (CNS) depressants, opioids, and stimulants) were assessed to identify differences among student characteristics, as well as their relationship with abuse. Purpose: The purpose of this study is to conduct a secondary analysis to explore demographic variables (race, gender, academic performance, living arrangement, alcohol and other drug usage, and …

The Association Between Domestic Violence, Hiv Status And Consent To Testing Among Zambian Women, Kara Nelson

Theses and Dissertations

In the past twenty years a global trend has emerged illustrating increasing rates of violence against women, with HIV rates among this population also steadily on the rise. Despite the burden of the problem, there is scant corpus of literature exploring the influence of domestic violence on HIV. Therefore, this study examined the association between domestic violence and women’s decision to consent to HIV testing, and their HIV status. Using the 2007 Zambia Demographic and Health Survey, it was found that Zambian women who have experienced domestic violence are 13% more likely to consent to an HIV test. After adjusting …

Is Food Insecurity A Contributing Factor To Childhood Obesity? The Association Of Household Food Insecurity And Obesity Prevalence Among Children And Adolescents In The United States, Zarah Liz Panaguiton

Theses and Dissertations

The obesity epidemic is a major public health concern, where the prevalence rates amongst the American children population have more than doubled since the 1980s. Among overweight children, the risk of becoming an overweight or obese adult is 70% higher than children of normal weight, and obese children are more likely to remain obese into adulthood and face a number of morbidities associated with it, including lower quality of life and increased financial burden. In this research, we examined the relationship between household food security and obesity among children and adolescents between the ages of 2-18 years old. We used …

The Epidemiology Of Snakebite Injury In The Amazonian Regions Of Ecuador, Sarah Stuppy

Theses and Dissertations

The epidemiology of snakebite injury in the Amazonian regions of Ecuador Introduction: Morbidity and mortality from snakebite envenomations is a major public health issue in remote areas of under-developed countries. Several attempts have been made to approximate the impact of snakebites worldwide, however these are assumed to be underestimations due to the lack of documentation on the local level. Ecuador's Amazonian region lacks a comprehensive community-based surveillance system, however it is unique in that an aero-medical transport system is in place to transfer the patients requiring hospitalization to one of the five urban medical centers. Beginning in 1998, Servicio Aéreo …

Master Of Public Health Research Project: Unmarried Women In Ghana, Africa: Predictors Of Condom Use- An Analysis Of The 2008 Ghana Demographic And Health Survey/Questionnaire Database, Emilie Hill

Theses and Dissertations

Background: Many factors affect whether women will insist that their sexual partners use a condom. This research project will identify some of the predictors of condom use among unmarried women in Ghana, Africa. Methods: This research project evaluated data from the 2008 DHS of women in Ghana, Africa for predictors of condom use among unmarried women. A total of 4,916 women completed the surveys. Of these, 1,966 women were unmarried. The research project employed multiple logistic regression analysis to determine condom use predictors at the time of the last sexual encounter for these 1,966 unmarried women. Results: Women with a …

When Volunteering Doesn’T Cut It: A Critical Examination Of Carbapenem-Resistant Enterobacteriaceae Surveillance And Trends In The United States., Erica E. Smith

Theses and Dissertations

Background. Carbapenem-resistant Enterobacteriaceae, including Escherichia coli and Klebsiella pneumoniae, are newly emerging pathogens of public health importance. Currently no nationally representative or mandatory surveillance or reporting system exists to examine trends of these important pathogens. Objective. The purpose of the current study was to estimate trends in overall microbial burden and carbapenem resistance in E. coli and K. pneumoniae and to understand the extent to which hospitals which report to voluntary surveillance systems represent all hospitals in the United States. Design. We conducted a descriptive study to compare the hospitals participating in voluntary reporting systems of the University HealthSystem Consortium …

Everything's Better In Moderation: Young Women's Gender Role Attitudes And Risky Sexual Behavior, Tamara Leech

Department of Public Health Scholarship and Creative Works

Purpose This study examines the association between gender role attitudes and risky sexual behavior among young women. Previous studies have posed seemingly contradictory arguments: that either traditional attitudes or egalitarian attitudes are associated with riskier behavior. Methods Data are based on the children of the National Longitudinal Survey of Youth, representing 520 sexually active 18–19-year-old women. Propensity radius matching was used to assess differences in rates of multiple sexual partners and sex outside of a committed relationship. Results Relative to moderate gender role attitudes, both egalitarian gender role attitudes and traditional gender role attitudes are associated with higher rates of …

Oral Cancer In Nevada: A Public Health Perspective, Karl Kingsley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cancer is the second leading cause of death in the United States, and oral cancer remains the eighth leading cause of cancer death among US males. Although previous epidemiologic studies have found that overall rates of cancer, including oral cancer, have declined in the US in recent decades – these declines are neither uniform nor consistent within this population. Anecdotal evidence has suggested that rates of oral cancer in Nevada are relatively high, although no evidence was available to support these assertions.

Oral Cancer Epidemiology: Based upon this information, a detailed and thorough epidemiologic examination of oral cancer rates in …

Kesehatan Jiwa Di Indonesia Dari Deinstitusionalisasi Sampai Desentralisasi, Sri Idaiani

Kesmas

Deinstitusionalisasi adalah kebijakan di bidang kesehatan jiwa yang dimulai di negara-negara maju sekitar tahun 1950. Kebijakan tersebut telah dilakukan di Indonesia, meskipun informasi tentang keberhasilan dan kegagalan masih terbatas pada pendapat profesional di kalangan psikiatri. Disaat program ini belum sepenuhnya berhasil, Indonesia mengalami perubahan politik yang mengantarkan pada kebijakan desentralisasi. Pada saat yang bersamaan, muncul masalah kekurangan tenaga dokter spesialis psikiater. Tujuan analisis ini adalah untuk melakukan kajian terhadap berbagai masalah yang berkaitan dengan psikiater dan deinstitusionalisasi pada era desentralisasi. Dalam artikel ini disajikan beberapa kondisi yang terjadi di negara lain serta kajian terhadap kebijakan yang ada di Indonesia. Berdasarkan …

Perbandingan Dua Metode Estimasi Pajanan Pestisida Di Tempat Kerja, Nurhayati Prihartono

Kesmas

Informasi yang valid tentang pajanan masa lalu mungkin sulit didapat dari wawancara individu. Peran ahli seperti higiene industri atau pertanian dalam mengestimasi pajanan pestisida dengan menggunakan jenis pekerjaan dapat meningkatkan validitas data pajanan. Penelitian ini bertujuan membandingkan pajanan pestisida di tempat kerja yang ditentukan berdasarkan laporan individu dan ahli, serta mempelajari pola perbedaan tingkat pajanan dari kedua metode tersebut. Laporan individu berasal dari studi kasus kontrol tentang anemia aplastik di Thailand. Estimasi ahli digunakan untuk menentukan tingkat pajanan terhadap 4 jenis pestisida pada setiap 476 jenis pekerjaan. Instrumen standar dibuat berdasarkan probabilitas pajanan, frekuensi, intensitas dan keyakinan diri dalam menentukan …

Nonparametric Regression With Missing Outcomes Using Weighted Kernel Estimating Equations, Lu Wang, Andrea Rotnitzky, Xihong Lin

Harvard University Biostatistics Working Paper Series

No abstract provided.

Sensitivity Analysis – The Effects Of Glasgow Outcome Scale Misclassification On Traumatic Brain Injury Clinical Trials, Juan Lu

Theses and Dissertations

I. EFFECTS OF GLASGOW OUTCOME SCALE MISCLASSIFICATION ON TRAUMATIC BRAIN INJURY CLINICAL TRIALS The Glasgow Outcome Scale (GOS) is the primary endpoint for efficacy analysis of clinical trials in traumatic brain injury (TBI). Accurate and consistent assessment of outcome after TBI is essential to the evaluation of treatment results, particularly in the context of multicenter studies and trials. The inconsistent measurement or interobserver variation on GOS outcome, or for that matter, on any outcome scales, may adversely affect the sensitivity to detect treatment effects in clinical trial. The objective of this study is to examine effects of nondifferential misclassification of …

The Impact Of Coarsening The Explanatory Variable Of Interest In Making Causal Inferences: Implicit Assumptions Behind Dichotomizing Variables, Ori M. Stitelman, Alan E. Hubbard, Nicholas P. Jewell

U.C. Berkeley Division of Biostatistics Working Paper Series

It is common in analyses designed to estimate the causal effect of a continuous exposure/treatment to dichotomize the variable of interest. By dichotomizing the variable and assessing the causal effect of the newly fabricated variable practitioners are implicitly making assumptions. However, in most analyses these assumptions are ignored. In this article we formally address what assumptions are made in dichotomizing variables to assess causal effects. We introduce two assumptions, either of which must be met, in order for the estimates of the causal effects to be unbiased estimates of the parameters of interest. We title those assumptions the Mechanism Equivalence …

Hiv Risk Factors Among Moroccan And Turkish Same-Sex Attracted Youth In Amsterdam, Daniel Woznica

Independent Study Project (ISP) Collection

This report is the outcome of a month-long exploratory study on the main HIV risk factors among Moroccan and Turkish same-sex attracted (SSA) youth in Amsterdam. Data was obtained by way of interviews conducted with five experts, categorized as: academics, sexual and ethnic minority activists, and HIV professionals. Five main risk factors were determined: cultural differences; language barriers; stigma and taboo around sexuality and HIV within Islamic communities; socioeconomic marginalization; and lack of a positive term for same-sex sexual behavior and identity among the target group. Recommendations for future research include interviews with Moroccan and Turkish SSA youth themselves. Implications …

A Gis Analysis Of The Environmental Variables Related To Rift Valley Fever Outbreaks, Jacqueline Florette Jackson

Health Services Research Dissertations

Rift Valley fever is a mosquito-borne disease that causes widespread febrile illness and mortality in domestic animals as well as humans (Gaff, 2007). Rift Valley fever virus was first isolated in 1931 (Daubney, 1931), and since then, outbreaks have occurred in sub-Saharan Africa, southern Africa, Egypt, Saudi Arabia, Yemen and Madagascar, proving it to be a virus able to invade ecologically diverse regions (Gaff, 2007). The potential introduction of Rift Valley fever into the United States suggests the potential for human infection and major economic disruption. It is important to understand the role environmental variables have played in historical outbreaks …

Effects Of Leas And Mecury On The Blood Proteome Of Children, Robert E. Birsall, Michael P. Kiley, Zaneer M. Segu, Christopher D. Palmer, Milan Madera, Brooks B. Gump

Falk College Research Center

Heavy metal exposure in children has been associated with a variety of physiological and neurological problems. The goal of this study was to utilize proteomics to enhance the understanding of biochemical interactions responsible for the health problems related to lead and mercury exposure at concentrations well below CDC guidelines. Blood plasma and serum samples from 34 children were depleted of their most abundant proteins using antibody-based affinity columns and analyzed using two different methods, LC-MS/MS and 2-D electrophoresis coupled with MALDI-TOF/MS and tandem mass spectrometry. Apolipoprotein E demonstrated an inverse significant association with lead concentrations (average being one microgram/deciliter) as …

Identifikasi Penyebab Diare Di Kabupaten Karangasem, Bali, I N. Sujaya, N.P. Desy Aryantini, N.W. Nursini, S.G. Purnama, N.M.U. Dwipayanti, I G. Artawan, I M. Sutarga

Kesmas

Pada Februari hingga Maret 2008 terjadi kejadian luar biasa muntah berak (diare) di Kabupaten Karangasem Bali. Tercatat sekitar 600 orang mengalami muntaber dan 5 orang meninggal dunia. Ini merupakan kejadian KLB muntaber pertama kali di Bali serta belum diketahui patogen penyebab diare tersebut. Tujuan penelitian ini adalah mengidentifikasi penyebab diare di Karangasem serta kemungkinan rantai penularannya. Penelusuran penyebab KLB dilakukan dengan menganalisis sampel air yang diambil dari sumber air umum, cubang/sumur penduduk, bahan makanan, serta rectal swab penderita dengan kombinasi teknik pemupukan kuman dan PCR spesifik dengan target gen pembentuk toksin pada Escherichia coli. Dengan melakukan kultur pada sampel makanan …

Malaria And Helminth Co-Infections In Outpatients Of Alaba Kulito Health Center, Southern Ethiopia: A Cross Sectional Study, Abraham Degarege, Abebe Animut, Mengistu Legesse, Berhanu Erko

Journal Articles: Epidemiology

BACKGROUND: Distribution of malaria and intestinal helminths is known to overlap in developing tropical countries of the world. Co-infections with helminth and malaria parasites cause a significant and additive problem against the host. The aim of this study was to asses the prevalence of malaria/helminth co-infection and the associated problems among febrile outpatients that attended Alaba Kulito Health Center, southern Ethiopia November and December 2007. A total of 1802 acute febrile patients were diagnosed for malaria. 458 Giemsa-stained thick and thin blood films were used for identification of Plasmodium species and Stool samples prepared using Kato-Katz technique were used to …

Safety Assessment For Tipranavir : A Protease Inhibitor Treatment For Hiv Infected Adults, Jaromir Mikl

Legacy Theses & Dissertations (2009 - 2024)

Dose-limiting adverse events associated with anti-retroviral therapy (ART) generally include gastro-intestinal (GI) issues such as vomiting and nausea. However, serious adverse events (SAEs) do occur, the most frequent of which include liver toxicities and renal impairment as well as recent evidence of cardio-vascular disease (CVD) risk.

Respondent Driven Sampling : Feasibility, Validation And Its Potential Use For Estimating Health Indicators For Large General Populations, Robin Lee

Legacy Theses & Dissertations (2009 - 2024)

BACKGROUND: Researchers use many methods to collect population-based health indicator data. Random digit dial (RDD) is one frequently used method; however decreasing sample coverage and non-response bias have researchers searching for alternative methods. We hypothesize that respondent driven sampling (RDS) is a cost effective alternative. In accordance with this hypothesis we propose three objectives: 1) assess the mechanics, feasibility, and representativeness of RDS in producing valid estimates of health indicator data; 2) evaluate the feasibility in using RDS in comparison to RDD to collect health indicator data from a general population; and 3) report on data collected using RDS, specifically …

The Utility Of The Behavioral Risk Factor Surveillance System In Testing Quality Of Life Theory : An Evaluation Using Structural Equation Modeling, Evelyn Marie Kintner

Legacy Theses & Dissertations (2009 - 2024)

This study is a secondary data analysis that uses structural equation modeling (SEM) to assess the utility of the Behavioral Risk Factor Surveillance System (BRFSS)--the Centers for Disease Control's premier surveillance tool for monitoring behavioral risk factors--in predicting health related quality of life (HRQoL). Employing the statistical package SPSS/AMOS (version 7), the study utilizes New York State data extracted from the 2007 BRFSS national dataset to assess how well the observed pattern of variances and covariances of the state level data fit with a well-known HRQoL model developed by Wilson and Cleary (1995). Interaction effects are examined, utilizing a multigroup …

Prevention Of Human Papillomavirus (Hpv) Infection And Hpv-Related Diseases : Barriers To Hpv Vaccine Coverage Among University Women In The U.S., And Initial Steps In Integrating Cervical Cytology Testing Into Primary Care In The Republic Of Georgia, Robert Bednarczyk

Legacy Theses & Dissertations (2009 - 2024)

Worldwide, cervical cancer is second only to breast cancer in incidence. Screening for pre-cancerous abnormalities can reduce cervical cancer incidence and mortality, though this is not uniformly used worldwide. Recently, a vaccine against human papillomavirus (HPV), a necessary cause of cervical cancer, was approved for preventive use in the United States.