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Intersectional Effects Of Racial And Gender Discrimination On Cardiovascular Health Vary Among Black And White Women And Men In The Cardia Study, Ganga S. Bey, William M. Jesdale, Sarah N. Forrester, Sharina D. Person, Catarina I. Kiefe 2019 University of North Carolina at Chapel Hill

Intersectional Effects Of Racial And Gender Discrimination On Cardiovascular Health Vary Among Black And White Women And Men In The Cardia Study, Ganga S. Bey, William M. Jesdale, Sarah N. Forrester, Sharina D. Person, Catarina I. Kiefe

Open Access Publications by UMMS Authors

Testing hypotheses from the emerging Identity Pathology (IP) framework, we assessed race-gender differences in the effects of reporting experiences of racial and gender discrimination simultaneously compared with racial or gender discrimination alone, or no discrimination, on future cardiovascular health (CVH). Data were from a sample of 3758 black or white adults in CARDIA, a community-based cohort recruited in Birmingham, AL; Chicago, IL; Minneapolis, MN, and Oakland, CA in 1985-6 (year 0). Racial and gender discrimination were assessed using the Experiences of Discrimination scale. CVH was evaluated using a 12-point composite outcome modified from the Life's Simple 7, with higher ...


Patient Sex And Physician Adherence To Treatment Guidelines For Non-Purulent Cellulitis, Rebecca Goldberg 2019 University of Massachusetts Amherst

Patient Sex And Physician Adherence To Treatment Guidelines For Non-Purulent Cellulitis, Rebecca Goldberg

Masters Theses

In 2015, participating US Emergency Departments (EDs) reported approximately 2.8 million visits related to skin and soft tissue infections (SSTIs). Studies indicate that there may be disparities by patient sex in physician treatment guideline adherence rates as a result of a gender bias during physician-patient interactions; however, only two epidemiologic studies have investigated the role of patient sex in guideline adherence rates for SSTIs. These prior studies were limited in size and covariate assessment. Thus, the magnitude and direction of the effect of patient sex is uncertain, warranting further research. Therefore, we conducted a large prospective study to elucidate ...


Changing Trends In The Landscape Of Patients Hospitalized With Acute Myocardial Infarction (2001 To 2011): The Worcester Heart Attack Study, Regino Mercado-Lubo 2019 University of Massachusetts Medical School

Changing Trends In The Landscape Of Patients Hospitalized With Acute Myocardial Infarction (2001 To 2011): The Worcester Heart Attack Study, Regino Mercado-Lubo

GSBS Dissertations and Theses

Background: During the past 50 years, novel diagnostic tools, interventional approaches, and population-wide changes in the major coronary risk factors have occurred. However, few studies have examined relatively recent trends in the demographic characteristics, clinical profile, and the short-term outcomes of patients hospitalized for acute myocardial infarction (AMI) from the more generalizable perspective of a population-based investigation.

Methods:We examined decade long trends (2001 to 2011) in patient’s demographic and clinical characteristics, treatment practices, and hospital outcomes among residents of the Worcester metropolitan area hospitalized with a validated initial AMI (n = 3,730) at all 11 greater Worcester medical ...


An Application Of The Modifiable Areal Unit Problem: Optimizing Cluster Method Parameters To Produce Predictive Data For Hiv Outbreaks, Connor J. Chato, Art FY Poon 2019 Western University

An Application Of The Modifiable Areal Unit Problem: Optimizing Cluster Method Parameters To Produce Predictive Data For Hiv Outbreaks, Connor J. Chato, Art Fy Poon

Western Research Forum

Background

A popular approach to study HIV outbreaks is to cluster cases based on genetic similarity. However, there is no widely-used statistical criterion which optimizes the parameters for sequence-based clustering methods. The relationship between a cluster-defining similarity threshold and it’s associated set of clusters can be analogized to the aggregation level in the Modifiable Areal Unit Problem (MAUP).

Hypothesis

Based on the selection of aggregation level for study partitions in MAUP, we present a statistical framework to optimize the similarity threshold for pairwise distance algorithm TN93 (http://github.com/veg/tn93). We hypothesize that defining this threshold includes case ...


Risk Of Cancer Death Among White, Black, And Hispanic Populations In South Florida, Paulo S. Pinheiro, Karen E. Callahan, Tulay Koru-Sengul, Justine Ransdell, Layla Bouzoubaa, Clyde P. Brown, Erin Kobetz 2019 University of Miami School of Medicine

Risk Of Cancer Death Among White, Black, And Hispanic Populations In South Florida, Paulo S. Pinheiro, Karen E. Callahan, Tulay Koru-Sengul, Justine Ransdell, Layla Bouzoubaa, Clyde P. Brown, Erin Kobetz

Environmental & Occupational Health Faculty Publications

Background: The cancer burden in South Florida, with a population of more than 6 million with a heavily Hispanic and large Afro-Caribbean population, has not been quantified. Methods: We analyzed 2012–2016 cancer mortality data from South Florida for white, Hispanic, and black populations with disaggregation for Cuban, Puerto Rican, South American, African American, and Afro-Caribbean groups. We calculated cancer site-specific and all-sites combined age-adjusted mortality rates, and we used negative binomial regression to determine mortality rate ratios to compare South Florida’s cancer mortality rates with those of the rest of the nation. Results: We analyzed 53,837 cancer ...


Neighborhood-Level Predictors Of Obesity Among African American Children In California, Uche Onyeka 2019 Walden University

Neighborhood-Level Predictors Of Obesity Among African American Children In California, Uche Onyeka

Journal of Social, Behavioral, and Health Sciences

The increased prevalence of childhood obesity is a major public health concern nationally and globally. Childhood obesity is primarily caused by the imbalance between caloric intake and caloric expenditure; however, its increase over the past decades may be due to environmental and behavioral factors. The purpose of the current study was to examine if any relationships existed between childhood obesity, level of physical activity, and neighborhood-level risk factors. This study used the California Health Interview Survey 2009–2014 data sets for African American children aged 5–11 years (n = 1,049). The dependent variable was body mass index (BMI) while ...


Lipoprotein(A) Plasma Levels, Bone Mineral Density And Risk Of Hip Fracture: A Post Hoc Analysis Of The Women's Health Initiative, Usa, Bernhard Haring, Carolyn J. Crandall, Laura Carbone, Simin Liu, Wenjun Li, Karen C. Johnson, Jean Wactawski-Wende, Aladdin H. Shadyab, Margery L. Gass, Victor Kamensky, Jane A. Cauley, Sylvia Wassertheil-Smoller 2019 University of Würzburg

Lipoprotein(A) Plasma Levels, Bone Mineral Density And Risk Of Hip Fracture: A Post Hoc Analysis Of The Women's Health Initiative, Usa, Bernhard Haring, Carolyn J. Crandall, Laura Carbone, Simin Liu, Wenjun Li, Karen C. Johnson, Jean Wactawski-Wende, Aladdin H. Shadyab, Margery L. Gass, Victor Kamensky, Jane A. Cauley, Sylvia Wassertheil-Smoller

Wenjun Li

OBJECTIVES: Elevated Lipoprotein(a) (Lp[a]) is a well-known risk factor for cardiovascular disease. However, its roles in bone metabolism and fracture risk are unclear. We therefore investigated whether plasma Lp(a) levels were associated with bone mineral density (BMD) and incident hip fractures in a large cohort of postmenopausal women.

DESIGN: Post hoc analysis of data from the Women's Health Initiative (WHI), USA.

SETTING: 40 clinical centres in the USA.

PARTICIPANTS: The current analytical cohort consisted of 9698 white, postmenopausal women enrolled in the WHI, a national prospective study investigating determinants of chronic diseases including heart disease, breast ...


Vitamin Deficiencies Among Resettled Refugees In Buffalo, Ny, Tyler B. Evans, Myron Glick MD 2019 University of Southern California

Vitamin Deficiencies Among Resettled Refugees In Buffalo, Ny, Tyler B. Evans, Myron Glick Md

Journal of Refugee & Global Health

Background

Vitamin deficiency in the developing world is a considerable public health issue that is often overlooked. Refugees are some of the most vulnerable populations, since they rely almost exclusively on the nutrition provided by refugee camps. Buffalo, NY resettles the fourth largest number of refugees per capita among cities in the United States (US).

Objective

We examined the prevalence of vitamin A, B2, B12, and D deficiencies among refugees who had been recently resettled to Buffalo, NY and referred to our practice for assessment. Our exploratory objective was to examine potential differences in the prevalence of vitamin deficiencies among ...


Dietary Inflammatory Index And Sleep Quality In Southern Italian Adults, Justyna Godos, Raffaele Ferri, Filippo Caraci, Filomena I. I. Cosentino, Sabrina Castellano, Nitin Shivappa, James R. Hébert, Fabio Galvano, Giuseppe Grosso 2019 University of South Carolina

Dietary Inflammatory Index And Sleep Quality In Southern Italian Adults, Justyna Godos, Raffaele Ferri, Filippo Caraci, Filomena I. I. Cosentino, Sabrina Castellano, Nitin Shivappa, James R. Hébert, Fabio Galvano, Giuseppe Grosso

Faculty Publications

Background: Current evidence supports the central role of a subclinical, low-grade inflammation in a number of chronic illnesses and mental disorders; however, studies on sleep quality are scarce. The aim of this study was to test the association between the inflammatory potential of the diet and sleep quality in a cohort of Italian adults. Methods: A cross-sectional analysis of baseline data of the Mediterranean healthy Eating, Aging, and Lifestyle (MEAL) study was conducted on 1936 individuals recruited in the urban area of Catania during 2014-2015 through random sampling. A food frequency questionnaire and other validated instruments were used to calculate ...


Anticoagulant Use, Safety And Effectiveness For Ischemic Stroke Prevention In Nursing Home Residents With Atrial Fibrillation, Matthew Alcusky 2019 University of Massachusetts Medical School

Anticoagulant Use, Safety And Effectiveness For Ischemic Stroke Prevention In Nursing Home Residents With Atrial Fibrillation, Matthew Alcusky

GSBS Dissertations and Theses

Background

Fewer than one-third of nursing home residents with atrial fibrillation were treated with the only available oral anticoagulant, warfarin, historically. Management of atrial fibrillation has transformed in recent years with the approval of 4 direct-acting oral anticoagulants (DOACs) since 2010.

Methods

Using the national Minimum Data Set 3.0 linked to Medicare Part A and D claims, we first described contemporary (2011-2016) warfarin and DOAC utilization in the nursing home population (Aim 1). In Aim 2, we linked residents to nursing home and county level data to study associations between resident, facility, county, and state characteristics and anticoagulant treatment ...


Opioid Overdose Deaths And Potentially Inappropriate Opioid Prescribing Practices (Pip): A Spatial Epidemiological Study, Thomas J. Stopka, Harsha Amaravadi, Anna R. Kaplan, Rachel Hoh, Dana Bernson, Kenneth K.H. Chui, Thomas Land, Alexander Y. Walley, Marc R. LaRochelle, Adam J. Rose 2019 Tufts University

Opioid Overdose Deaths And Potentially Inappropriate Opioid Prescribing Practices (Pip): A Spatial Epidemiological Study, Thomas J. Stopka, Harsha Amaravadi, Anna R. Kaplan, Rachel Hoh, Dana Bernson, Kenneth K.H. Chui, Thomas Land, Alexander Y. Walley, Marc R. Larochelle, Adam J. Rose

Open Access Publications by UMMS Authors

INTRODUCTION: Opioid overdose deaths quintupled in Massachusetts between 2000 and 2016. Potentially inappropriate opioid prescribing practices (PIP) are associated with increases in overdoses. The purpose of this study was to conduct spatial epidemiological analyses of novel comprehensively linked data to identify overdose and PIP hotspots.

METHODS: Sixteen administrative datasets, including prescription monitoring, medical claims, vital statistics, and medical examiner data, covering >98% of Massachusetts residents between 2011-2015, were linked in 2017 to better investigate the opioid epidemic. PIP was defined by six measures: > /=100 morphine milligram equivalents (MMEs), co-prescription of benzodiazepines and opioids, cash purchases of opioid prescriptions, opioid prescriptions ...


Pneumococcal Epidemiology Among Us Adults Hospitalized For Community-Acquired Pneumonia, Raul E. Isturiz, Julio Ramirez, Wesley H. Self, Carlos G. Grijalva, Francis L. Counselman, Gregory A. Volturo, Luis Ostrosky-Zeichner, Paula Peyrani, Richard G. Wunderink, Robert Sherwin, J. Scott Overcash, Senen Pena Oliva, Thomas File, Timothy L. Wiemken, John M. McLaughlin, Michael W. Pride, Sharon Gray, Ronika Alexander, Kimbal D. Ford, Qin Jiang, Luis Jodar 2019 Pfizer, Inc.

Pneumococcal Epidemiology Among Us Adults Hospitalized For Community-Acquired Pneumonia, Raul E. Isturiz, Julio Ramirez, Wesley H. Self, Carlos G. Grijalva, Francis L. Counselman, Gregory A. Volturo, Luis Ostrosky-Zeichner, Paula Peyrani, Richard G. Wunderink, Robert Sherwin, J. Scott Overcash, Senen Pena Oliva, Thomas File, Timothy L. Wiemken, John M. Mclaughlin, Michael W. Pride, Sharon Gray, Ronika Alexander, Kimbal D. Ford, Qin Jiang, Luis Jodar

Open Access Publications by UMMS Authors

BACKGROUND: Few studies have measured the burden of adult pneumococcal disease after the introduction of 13-valent pneumococcal conjugate vaccine (PCV13) into the US infant vaccination schedule. Further, most data regarding pneumococcal serotypes are derived from invasive pneumococcal disease (IPD), which represents only a fraction of all adult pneumococcal disease burden. Understanding which pneumococcal serotypes cause pneumonia in adults is critical for informing current immunization policy. The objective of this study was to measure the proportion of radiographically-confirmed (CXR+) community-acquired pneumonia (CAP) caused by PCV13 serotypes in hospitalized US adults.

METHODS: This observational, prospective surveillance study recruited hospitalized adults aged > /=18years ...


Impact Of Cardiac- And Noncardiac-Related Conditions On Adverse Outcomes In Patients Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, Jerry H. Gurwitz, Ruben Miozzo, Joel M. Gore, Darleen M. Lessard, Jorge L. Yarzebski, Robert J. Goldberg 2019 University of Massachusetts Medical School

Impact Of Cardiac- And Noncardiac-Related Conditions On Adverse Outcomes In Patients Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, Jerry H. Gurwitz, Ruben Miozzo, Joel M. Gore, Darleen M. Lessard, Jorge L. Yarzebski, Robert J. Goldberg

Open Access Publications by UMMS Authors

Background: To examine the impact of cardiac- and noncardiac-related conditions on the risk of hospital complications and 7- and 30-day rehospitalizations in older adult patients with an acute myocardial infarction (AMI).

Methods and Results: The study population consisted of 3863 adults aged 65 years and older hospitalized with AMI in Worcester, Massachusetts, during six annual periods between 2001 and 2011. Individuals were categorized into four groups based on the presence of 11 previously diagnosed cardiac and noncardiac conditions. The median age of the study population was 79 years and 49% were men. Twenty-eight percent of patients had two or less ...


A Case-Study Approach To Investigate Transmission, Co-Infection, And Clinical Sequelae During Epidemics Of Dengue And Ebola Virus Disease, Jennifer Elizabeth Giovanni 2019 Louisiana State University

A Case-Study Approach To Investigate Transmission, Co-Infection, And Clinical Sequelae During Epidemics Of Dengue And Ebola Virus Disease, Jennifer Elizabeth Giovanni

LSU Doctoral Dissertations

From within their ecologic niches, zoonotic viruses emerge from animal reservoirs into the edges and centers of human habitation to exploit opportunities for unabated transmission within immunologically–naïve populations. Our understanding of where, in whom, and how these viruses emerge is under direct challenge, driving the evolution of modern infectious disease epidemiology within a rapidly-connected global community. The studies presented herein are based on analyses of both aggregate and case-level data, which, we argue, provide unique insight into the complexities of transmission, co-infection, and clinical sequelae occurring within, and arising from, epidemics of emerging zoonotic viruses. In Chapter II, we ...


Impact Of Disclosure Of Military Service History On Diagnosis Of Ptsd, Crystal Shelton 2019 University of Pennsylvania

Impact Of Disclosure Of Military Service History On Diagnosis Of Ptsd, Crystal Shelton

Doctorate in Social Work (DSW) Dissertations

Objective Variability in how clinicians diagnose PTSD has been studied across treatment settings. Research shows several factors impact diagnostic variability. The purpose of this study was to evaluate the extent to which disclosure of military service leads to an increase in diagnosis of PTSD when considering an otherwise vague symptom profile. We hypothesize veteran status will increase the likelihood of a PTSD diagnosis than status as a teacher. Methods Clinician were recruited online through professional message boards and listservs. Participants were randomly assigned a vignette (veteran or teacher status) and subsequently asked to make diagnostic judgments. Two vignettes, identical with ...


Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani 2019 Duquesne University

Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani

Electronic Theses and Dissertations

As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding ...


Healthcare Disparities And Noncompliance In Children And Young Adults With Crohn’S Disease, Robert McLoughlin 2019 University of Massachusetts Medical School

Healthcare Disparities And Noncompliance In Children And Young Adults With Crohn’S Disease, Robert Mcloughlin

GSBS Dissertations and Theses

Objective:

Treatment compliance in children with Crohn’s disease is associated with higher levels of symptom remission. We hypothesized that the management, comorbidities, and complications for children with Crohn’s disease would differ based on a diagnosis of noncompliance.

Methods:

Using the Kids’ Inpatient Database for 2006-2012, we identified young patients (<21 >years) with a diagnosis of Crohn’s disease. Diagnoses and procedures were analyzed according to a recorded diagnosis of noncompliance. Multivariable logistic regression analysis was performed to examine the association between noncompliance and the outcomes of interest.

Results:

There were 28,337 pediatric Crohn’s disease hospitalizations identified with ...


Changes In Anticoagulant Utilization Among United States Nursing Home Residents With Atrial Fibrillation From 2011 To 2016, Matthew Alcusky, David D. McManus, Anne L. Hume, Marc Fisher, Jennifer Tjia, Kate L. Lapane 2019 University of Massachusetts Medical School

Changes In Anticoagulant Utilization Among United States Nursing Home Residents With Atrial Fibrillation From 2011 To 2016, Matthew Alcusky, David D. Mcmanus, Anne L. Hume, Marc Fisher, Jennifer Tjia, Kate L. Lapane

Open Access Publications by UMMS Authors

Background: Nursing home residents with atrial fibrillation are at high risk for ischemic stroke and bleeding events. The most recent national estimate (2004) indicated less than one third of this high-risk population was anticoagulated. Whether direct-acting oral anticoagulant ( DOAC ) use has disseminated into nursing homes and increased anticoagulant use is unknown.

Methods and Results: A repeated cross-sectional design was used to estimate the point prevalence of oral anticoagulant use on July 1 and December 31 of calendar years 2011 to 2016 among Medicare fee-for-service beneficiaries with atrial fibrillation residing in long-stay nursing homes. Nursing home residence was determined using Minimum ...


Segmental Distribution Of Hepatocellular Carcinoma Correlates With Microvascular Invasion In Liver Explants Undergoing Transplantation, Yasir Al-Azzawai, Eva Rouanet, Ryan J. Hendrix, Lidia Spaho, Hesham Malik, Deepika Devuni, Gyongyi Szabo, Graham Barnard 2019 University of Massachusetts Medical School

Segmental Distribution Of Hepatocellular Carcinoma Correlates With Microvascular Invasion In Liver Explants Undergoing Transplantation, Yasir Al-Azzawai, Eva Rouanet, Ryan J. Hendrix, Lidia Spaho, Hesham Malik, Deepika Devuni, Gyongyi Szabo, Graham Barnard

Open Access Publications by UMMS Authors

Introduction: Microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients is a poor prognostic factor after liver transplantation and/or resection. Any correlation between MVI and segmental location of HCC has yet to be studied. Our aim is to evaluate the segmental location of HCC and any correlation with the presence of MVI, portal vein thrombosis (PVT) in explanted livers, and the recurrence of HCC after transplantation. Another objective of the study is to assess the treatment history (ablation or transarterial chemoembolization (TACE)) and size of the tumor with respect to the risk of MVI.

Methods: A single center, retrospective chart ...


A Cross-Sectional Analysis Of Factors Associated With Detection Of Oncogenic Human Papillomavirus In Human Immunodeficiency Virus-Infected And Uninfected Kenyan Women, A. Ermel, P. Tonui, M. Titus, Y. Tong, N. Wong, J. Ong'echa, K. Muthoka, S. Kiptoo, Ann M. Moormann, J. Hogan, A. Mwangi, S. Cu-Uvin, P. J. Loehrer, O. Orang'o, D. Brown 2019 Indiana University

A Cross-Sectional Analysis Of Factors Associated With Detection Of Oncogenic Human Papillomavirus In Human Immunodeficiency Virus-Infected And Uninfected Kenyan Women, A. Ermel, P. Tonui, M. Titus, Y. Tong, N. Wong, J. Ong'echa, K. Muthoka, S. Kiptoo, Ann M. Moormann, J. Hogan, A. Mwangi, S. Cu-Uvin, P. J. Loehrer, O. Orang'o, D. Brown

Open Access Publications by UMMS Authors

BACKGROUND: Cervical cancer is caused by oncogenic human papillomaviruses (HPV) and is one of the most common malignancies in women living in sub-Saharan Africa. Women infected with the human immunodeficiency virus (HIV) have a higher incidence of cervical cancer, but the full impact on HPV detection is not well understood, and associations of biological and behavioral factors with oncogenic HPV detection have not been fully examined. Therefore, a study was initiated to investigate factors that are associated with oncogenic HPV detection in Kenyan women.

METHODS: Women without cervical dysplasia were enrolled in a longitudinal study. Data from enrollment are presented ...


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