Clinical Epidemiology Commons^™

A Decade Of Diabetes Hospitalizations: Meaningful Information For Community-Based Health Services Administrators For Identifying And Assessing Risk, Jewel Shepherd, Koren Goodman, Manasi Sheth-Chandra

Ellmer School of Nursing Faculty Publications

The American Diabetes Association has established that the largest contributor of expenditures related to the cost of care for diabetes is inpatient hospital care. Research has shown that when multiple hospitalizations have been examined, patients diagnosed with diabetes have higher same year readmission rates. Medicare-enrolled patients with coronary artery disease and diabetes who participated in a diabetes management intervention that included self-care behavior instructions and nurse management had fewer emergency room visits and hospitalizations for diabetes related care. In the US, an aging population and expected changes in the ethnic composition prompts an alert to actively address the need for …

Complementary And Alternative Medicine (Cam) And Adolescent Body Mass Index (Bmi): A National Population-Based Study, Laura Y. Defrain Lpn

Williams Honors College, Honors Research Projects

COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) AND ADOLESCENT BODY MASS INDEX (BMI): A NATIONAL POPULATION-BASED STUDY

Abstract

Background

Childhood obesity rates in the United States have remained around 17% since the 1990s - this figure translates to an estimated 12.7 million obese children. Maintaining a healthy weight through adolescence may limit subsequent health risks in adulthood. Complementary and alternative medicine (CAM) encompasses a variety of non-pharmacological treatments and lifestyle choices that have been utilized in addition to or in place of typical Western medicine. The relationship between adolescent Body mass index (BMI) and the use of complementary and alternative medicine has …

Nosocomial Infection In The Intensive Care Unit: Case Control Comparison Of Trauma Vs Surgical Vs Medical Patients, Catherine A. Fisher

Williams Honors College, Honors Research Projects

Clostridium difficille (C. difficile) is an infection-causing bacteria prevalent in hospital intensive care units (ICU). C. difficile infection (CDI) causes severe diarrhea and intestinal issues, while being highly contagious through resistant spores. Critically ill ICU patients are particularly vulnerable due to their weakened state and often high dosages of antibiotics. We investigated the differences between trauma, medical, and surgery patients that contracted C. difficile and developed an infection (CDI) in the ICU through retrospective chart analyses. Trauma patients had statistically significantly higher mean number of days on respiratory ventilation, days with a foley catheter, days in the ICU until …

‘Burnout Syndrome’: From Nosological Indeterminacy To Epidemiological Nonsense, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

All in all, Imo’s review is undermined by the very research it relies on. We recommend that researchers interested in burnout begin at the beginning, that is to say, by establishing a reasoned, clinically-founded (differential) diagnosis for their entity of interest. As long as investigators do not complete the required groundwork for establishing a diagnosis and remain unable to distinguish a case of burnout from either a noncase or an existing disorder, conclusions regarding the prevalence of burnout will be nonsense. To close this comment, we note that an immediately available solution for effectively monitoring and protecting physicians’ occupational health …

Consequences Of Job Stress For The Psychological Well-Being Of Teachers, Irvin Sam Schonfeld, Renzo Bianchi, Peter Luehring-Jones

Publications and Research

This chapter examines research on the relationship between job stressors and mental health (depressive symptoms, burnout, and mental disorders such as depression) in teachers. Teachers are exposed daily to job stressors (e.g., student disruptiveness) that have been linked to adverse mental health effects. Epidemiologic research indicates that when compared to members of other groups, teachers experience higher rates of mental disorder, although some studies question that conclusion. Large-scale studies indicate when compared to members of other occupational groups, teachers are at higher risk for exposure to workplace violence, with its adverse mental health consequences. Longitudinal research has linked teaching-related stressors …

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …

The Effect Of Agricultural Exposures And Genetics On Respiratory Phenotypes, Lisa W. Boyd

Theses & Dissertations

Agricultural workers are at risk for respiratory diseases, such as chronic obstructive pulmonary disease (COPD) and chronic bronchitis, due to exposures and inflammatory agents found in their work environment. While previous studies have been conducted to examine agricultural effects of chronic respiratory diseases more closely, there are still several significant gaps in the existing literature.

This dissertation explores the relationship between agricultural exposures and respiratory diseases. Utilizing two populations, the Keokuk Country Rural Health Study and the AgLung Study, this research: 1) used principal factor analysis (PFA) to distill exposure data into essential variables characterizing long-term agricultural exposures in order …

Vitamin D, Calcium And Blood Pressure In The U.S., Sarah Bean

Master's Projects and Capstones

Vitamin D and calcium have received increased attention for their potential roles in improving cardiovascular health. The active form of vitamin D, 1,25-hydroxyvitamin D (25[OH]D), may influence blood pressure by increasing gastrointestinal calcium absorption. The objectives of this study were to first examine the association between blood pressure and blood serum 25(OH)D levels, and then explore the interaction between 25(OH)D, calcium intake, and blood pressure. Cross-sectional analysis featured 24,844 U.S. adults aged 20-80 years from three cycles of the National Health and Examination Survey (NHANES 2001-2006). Linear regression models were used to determine the adjusted association of 25(OH)D categories with …

Determining The Incidence And Factors Of Cardiotoxicity In Breast Cancer Patients Treated With Anthracycline And/Or Trastuzumab-Containing Regimen At Aurora Health Care, Stephanie Ghojallu, Matthew Rappelt, Han-Yang Chen, Ruth Perez, Lydia Garlie, Geoffrey Riddell, Yingying Gu, Jun Zhang, Rubina Qamar, Bijoy K. Khandheria, Arshad Jahangir, Yang Shi

Journal of Patient-Centered Research and Reviews

Background: Anthracycline and trastuzumab are common breast cancer treatments. While improving survival, they elevate risk of congestive heart failure. The incidence of cardiotoxicity (CTx) with these therapies varies in the literature from 10% to 59%, higher than those reported in clinical trials (4%–10%) that excluded patients with preexisting cardiovascular comorbidities. Studies have failed to establish consensus on the risk factors for CTx associated with these therapies.

Purpose: We aim to determine the incidence and risk factors of CTx in breast cancer patients treated with anthracycline and/or trastuzumab at Aurora Health Care.

Methods: A retrospective review of patients with breast cancer …

Association Between Pregnancy Intention And Maternal Characteristics, Outcomes, And Cost Of Care: A Pilot Study, Kristy M. Kelel, Kiley B. Vander Wyst, Danielle M. Greer, Danish Siddiqui

Journal of Patient-Centered Research and Reviews

Background: An estimated 51% of pregnancies in the United States are unintended. In Wisconsin, unplanned pregnancies account for 40% of all pregnancies and cost $148 million in public funds. Unintended pregnancy, which creates increased hardship for mothers and threatened well-being of infants, has been recognized as an important health, social and economic problem.

Purpose: To determine the pregnancy intentions of postpartum women and the maternal characteristics, outcomes and costs of care associated with unintended pregnancies at a large urban hospital in Milwaukee, Wisconsin.

Methods: Postpartum women were surveyed prior to discharge. The 20-item survey included whether or not the woman …

Changing Diagnostic Methods And Increased Detection Of Verotoxigenic Escherichia Coli, Ireland, Thomas Rice, Noreen Quinn, Roy D. Sleator, Brigid Lucey

Department of Biological Sciences Publications

The recent paradigm shift in infectious disease diagnosis from culture-based to molecular-based approaches is exemplified in the findings of a national study assessing the detection of verotoxigenic Escherichia coli infections in Ireland. The methodologic changes have been accompanied by a dramatic increase in detections of non-O157 verotoxigenic E. coli serotypes.

Advancing Population Health: New Models And The Role Of Research. An Overview Of The 22nd Annual Health Care Systems Research Network Conference, Robert T. Greenlee, Lois E. Lamerato, Sarah M. Greene

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN; formerly HMO Research Network) held its annual conference in Atlanta, Georgia, in April 2016. A consortium of research organizations affiliated with 20 large health care delivery systems, the HCSRN met for the 22^nd consecutive year to report on scientific achievements, develop and share skills and best practices, and promote new research collaborations. The 2016 conference, with a theme of “Advancing Population Health: New Models and the Role of Research,” was co-hosted on behalf of HCSRN by Marshfield Clinic Research Foundation and Henry Ford Health System’s Public Health Sciences Department. The 350 conference …

Surveillance, Epidemiological, And Virological Detection Of Highly Pathogenic H5n1 Avian Influenza Viruses In Duck And Poultry From Bangladesh, Wahedul Karim Ansari, Md Safiullah Parvej, Mohamed E. El Zowalaty, Sally Jackson, Stephen A. Bustin, Adel K. Ibrahim, Md Tanvir Rahman, Han Zhang, Mohammad Ferdousur Rahman Khan, Md Mostakin Ahamd, Md. Fasiur Rahman, Marzia Rahman, Khm Nazmul H. Nazir, Sultan Ahmed, Md Liakot Hossenn, Md Abdul Kafi, Mat Yamage, Nitish C. Debnath, Graba Ahmed, Hossam Ashour, Md Masoud, Ayman Noreddin, Md B. Rahman

Pharmacy Faculty Articles and Research

Avian influenza viruses (AIVs) continue to pose a global threat. Waterfowl are the main reservoir and are responsible for the spillover of AIVs to other hosts. This study was conducted as part of routine surveillance activities in Bangladesh and it reports on the serological and molecular detection of H5N1 AIV subtype. A total of 2169 cloacal and 2191 oropharyngeal swabs as well as 1725 sera samples were collected from live birds including duck and chicken in different locations in Bangladesh between the years of 2013 and 2014. Samples were tested using virus isolation, serological tests and molecular methods of RT-PCR. …

Total Versus Partial Splenectomy In Pediatric Hereditary Spherocytosis: A Systematic Review And Meta-Analysis, Leonardo Guizzetti

Epidemiology and Biostatistics Publications

To compare the clinical effectiveness of total (TS) or partial (PS) splenectomy in pediatric hereditary spherocytosis, a systematic review and meta-analysis was performed (PROSPERO registration CRD42015030056). There were 14 observational studies comparing pre- and post- operative hematologic parameters. Secondary outcomes include in-hospital infections, surgical complications, symptomatic recurrence and biliary disease. TS is more effective than PS to increase hemoglobin (3.6 g/dL vs 2.2 g/dL) and reduce reticulocytes (12.5% vs 6.5%) after one year; outcomes following PS are stable for at least 6 years. There were no cases of overwhelming post-splenectomy sepsis. A population-based patient registry is needed for long-term follow-up.

"What's App?" Utilizing Evidence Based Medicine Apps In The Clinical Setting, Kathryn C. O'Donovan

BU Well

The medical community has utilized evidence-based medicine, or EBM, in practice for decades, and healthcare personnel are used to the idea of utilizing research and statistics to determine the treatment of patients. However, as technology advances, the use of electronics and EBM apps has increased in the clinical setting. While there are advantages to clinicians having resources at their fingertips as they talk with patients, there are also hurdles that could harm or offend patients. So as healthcare inevitably becomes more and more electronic, can providers strike the balance needed to effectively use EBM apps in practice to provide optimum …

Global Trends In Cancer Burden Based On Geographic Location, Socio-Economic Status And Demographic Shift, Sanjib Chowdhury

Theses & Dissertations

The global burden of cancer is rising at an alarming rate. It remains as one of the top causes of morbidity and mortality worldwide. It is predicted that within 2020, there will be 15 million new cases of cancer in the world, with cancer-related deaths increasing to 12 million. According to the World Health Organization (WHO), the global cancer burden is expected to surge 57% worldwide in the next 20 years. A significant rise in cancer burden will occur in the low-income and middle-income (developing) countries not only due to demographic shifts, but also by the transition of risk factors …

Modifiable Barriers To Optimal Outcomes In Gout Management, Brian W. Coburn

Theses & Dissertations

Improving patient outcomes in chronic disease is of critical importance to the future of health care. Gout, affecting 4% of the US population, is a highly treatable chronic disease from which patients experience unnecessarily suboptimal outcomes. In this dissertation, I demonstrate how interrelated patient and provider factors affect patient outcomes in gout. First, I describe how only 14% of gout patients know their serum urate (SU) goal for urate lowering therapy (ULT) despite otherwise being knowledgeable about gout and its treatment. I then demonstrate the importance of multiple patient and provider factors in achieving SU goal. Specifically, I demonstrate that …

Geodemographic Features Of Human Blastomycosis In Eastern Wisconsin, Megan E. Huber, Dennis J. Baumgardner, Jessica J. F. Kram, Melissa A. Lemke

Journal of Patient-Centered Research and Reviews

Purpose

Blastomycosis is an endemic fungal infection. In rural northern Wisconsin, blastomycosis cases are associated with certain environmental features including close proximity to waterways. Other studies have associated blastomycosis with particular soil chemicals. However, blastomycosis also occurs in urban and suburban regions. We explored the geodemographic associations of blastomycosis cases in the more urban/suburban landscape of eastern Wisconsin.

Methods

We conducted a retrospective study of 193 laboratory-identified blastomycosis cases in a single eastern Wisconsin health system, 2007–2015. Controls were 250 randomly selected cases of community-diagnosed pneumonia from a similar time period. Geographic features of home addresses were explored using Google …

Geographic Distribution Of Maternal Group B Streptococcus Colonization And Infant Death During Birth Hospitalization: Eastern Wisconsin, Jessica J. F. Kram, Dennis J. Baumgardner, Kiley B. Vander Wyst, Melissa A. Lemke

Journal of Patient-Centered Research and Reviews

Purpose

Maternal group B Streptococcus (GBS) can be transmitted from a colonized mother to newborn during vaginal delivery and may or may not contribute to infant death. This study aimed to explore the geographic distribution and risk factors of maternal GBS colonization and infant death during birth hospitalization.

Methods

We retrospectively studied mothers with live birth(s) in a large eastern Wisconsin hospital system from 2007 through 2013. Associations between maternal and neonatal variables, GBS colonization and infant death were examined using chi-squared, Mann-Whitney U and t-tests. Multivariable logistic regression models also were developed.

Results

Study population (N = 99,305) had …

The Role Of Mathematical Modeling In Designing And Evaluating Antimicrobial Stewardship Programs, Lester Caudill, Joanna R. Wares

Department of Math & Statistics Faculty Publications

Antimicrobial agent effectiveness continues to be threatened by the rise and spread of pathogen strains that exhibit drug resistance. This challenge is most acute in healthcare facilities where the well-established connection between resistance and sub-optimal antimicrobial use has prompted the creation of antimicrobial stewardship programs (ASPs). Mathematical models offer tremendous potential for serving as an alternative to controlled human experimentation for assessing the effectiveness of ASPs. Models can simulate controlled randomized experiments between groups of virtual patients, some treated with the ASP measure under investigation, and some without. By removing the limitations inherent in human experimentation, including health risks, study …