Epidemiology Commons^™

Assessing The Risk Of Developing Liver Cancer Among Adults In The United States, Magbor Oben

Walden Dissertations and Doctoral Studies

The risk of developing liver cancer among adults in the United States remains asignificant threat due to an increasing prevalence of the disease. Despite the identification of some biological, environmental, and socioeconomic risk factors, uncertainty exists as to the role of sociodemographic factors. In this study, participants (N=27,804), age 18 and over, were assessed for liver cancer outcome specific to three factors liver disease, insurance coverage, and access to healthcare. With the person-centered care model as the framework, data from the 2016 National Health and Interview Surveys were subjected to the selection criteria and quantitatively analyzed using binary logistic regression. …

Predictors Of Depression Screening Among Cancer Patients In U.S. Ambulatory Settings, Joseph Oluyinka Fawole

Walden Dissertations and Doctoral Studies

Depression is a common mental health comorbidity in cancer diagnoses, affecting 8-24% of cancer patients. Despite the high prevalence of depression among cancer patients, it is often unrecognized and untreated, thereby representing an enormous psychological distress source among the cancer patient population. The purpose of this study was to explore and establish the factors that predict depression screening among cancer patients in the ambulatory care setting in the United States. The health belief model guided the study. Secondary data from the National Ambulatory Medical Care Survey were analyzed to evaluate the predictors of depression screening in patients diagnosed with cancer. …

Maternal Proximity To Mountaintop Removal Mining And Birth Defects In Appalachian Kentucky, 1997-2003, Daniel B. Cooper

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Extraction of coal through mountaintop removal mining (MTR) alters many dimensions of the landscape, and explosive blasts, exposed rock, and coal washing have the potential to pollute air and water with substances known to increase risk of developmental and birth anomalies. Previous research suggests that infants born to mothers living in MTR coal mining counties have higher prevalence of most types of birth defects.

Objectives: This study seeks to examine further the relationship between MTR activity and birth defects by employing individual level exposure estimation through precise satellite data of MTR activity in the Appalachian region and maternal residence …

The Relationship Between Insurance And Health Outcomes Of Diabetes Mellitus Patients In Maryland: A Retrospective Archival Study, Soo-Hoon Lee, Samuel L. Brown, Andrew A. Bennett

Management Faculty Publications

Background

Past studies examining the health outcomes of diabetes mellitus (DM) patients found that social determinants of health disparities were associated with variabilities in health outcomes. However, improving access to healthcare, such as health insurance, should mitigate negative health outcomes. The aim of the study was to explore the association between four types of health insurance, namely, Medicare Fee-For-Service (FFS), Medicare Managed Care (MC), Private FFS, and Private MC plans, and the health outcomes of DM patients, controlling for patients’ social determinants of health.

Methods

This is a retrospective cross-sectional archival record study to explore the relationships between types of …

Association Between Race/Ethnicity And Covid-19 Disease Outcomes In The United States: A Qualitative Systematic Review Of The Literature, Jacob Smith

MEDI 9331 Scholarly Activities Clinical Years

Background/Objective: As studies have shown disparities in coronavirus disease-19 prevalence and severity, we sought to evaluate differences in outcomes of acute SARS-CoV-2 infection by race/ethnicity.

Design: Systematic review

Data Source: Studies from PubMed were included.

Review methods: Articles published in English language from January 1, 2019 through March 22, 2020. Studies included were observational studies that examined racial or ethnic disparities in SARS-CoV-2 infection outcomes in the United States. One reviewer performed data extraction.

Results: Out of a possible 1,944 articles, 99 observational studies (82 individual-level and 17 population-level) were included. Differential rates of hospitalization or otherwise severe illness …

Investigations Into The Genetics Of Mixed Pathologies In Dementia, Adam Dugan

Theses and Dissertations--Epidemiology and Biostatistics

Alzheimer’s disease (AD) is an irreversible, progressive brain disorder that leads to a loss of memory and thinking skills. While tremendous progress has been made in our understanding of the genetics underlying AD, currently known genetic variants explain only approximately 30% of the heritable risk of developing AD. One hurdle to AD research is that it can only be definitively diagnosed at autopsy, making cruder, clinic-based diagnoses more common. In recent years, several brain pathologies that mimic AD’s clinical presentation have been identified including brain arteriolosclerosis, hippocampal sclerosis (HS), and, most recently, limbic-predominant age-related TDP-43 encephalopathy (LATE). It has become …

An Assessment Of Kentucky Birth Records, Focusing On Early-Onset Hypertensive Disorders Of Pregnancy, Environmental Metal Exposures, And Geocoding Precision, 2008-2017, Courtney J. Walker

Theses and Dissertations--Epidemiology and Biostatistics

Using live and stillbirth records from Kentucky (2008-2017), this dissertation assessed the county-level prevalence and geospatial patterns of early-onset hypertensive disorders of pregnancy (eHDP); examined the geocoding precision of addresses recorded on birth records, and evaluated the association between individual risk factors and environmental metal exposures on eHDP prevalence. After adjusting for maternal demographic factors and pre-existing health conditions, we observed that eHDP prevalence was 38% higher (aPR=1.38, 95%CI:1.16, 1.64) in counties with the highest prevalence of married women (> 53.8%) compared to lower prevalence areas (31.6%) had a 20% higher prevalence of eHDP(aPR=1.20, 95%CI:1.00, 1.44) compared to counties with …

Implementación De Políticas De Prevención Y Control De La Obesidad Infantil En Estados Unidos Y Latinoamérica: Lecciones Para La Investigación Y La Práctica Transfronterizas, Mireya Vilar-Compte, Rafael Perez-Escamilla, Elizabeth Rhodes, Olga L. Sarmiento, Camila Corvalan, Rachel Sturke, Susan Vorkoper

Department of Public Health Scholarship and Creative Works

Aunque se han hecho avances en el desarrollo y aplicación a gran escala de inter-venciones eficaces contra la obesidad infantil, los retos siguen siendo importantes. Nuestro objetivo era comprender las causas del éxito de Estados Unidos y los países latinoamericanos en la implementación de políticas y programas (PYP) contra la obe-sidad e identificar oportunidades de mejora aplicando los principios de la ciencia de la implementación. Seleccionamos tres estudios de comparación de casos: (1) el etique-tado frontal en los envases de alimentos (México y Chile), (2) los programas de calles abiertas y calles para el juego (Colombia y Estados Unidos) y …

The Future Of Zoonotic Risk Prediction, Colin J. Carlson, Maxwell J. Farrell, Zoe Grange, Barbara A. Han, Nardus Mollentze, Alexandra L. Phelan, Angela L. Rasmussen, Gregory F. Albery, Bernard Bett, David Brett-Major, Lily E. Cohen, Tad Dallas, Evan A. Eskew, Anna C. Fagre, Kristian M. Forbes, Rory Gibb, Sam Halabi, Charlotte C. Hammer, Rebecca Katz, Jason Kindrachuk, Renata L. Muylaert, Felicia B. Nutter, Joseph Ogola, Kevin J. Olival, Michelle Rourke, Sadie J. Ryan, Noam Ross, Stephanie N. Seifert, Tarja Sironen, Claire J. Standley, Kishana Taylor, Marietjie Venter, Paul W. Webala

Journal Articles: Epidemiology

In the light of the urgency raised by the COVID-19 pandemic, global investment in wildlife virology is likely to increase, and new surveillance programmes will identify hundreds of novel viruses that might someday pose a threat to humans. To support the extensive task of laboratory characterization, scientists may increasingly rely on data-driven rubrics or machine learning models that learn from known zoonoses to identify which animal pathogens could someday pose a threat to global health. We synthesize the findings of an interdisciplinary workshop on zoonotic risk technologies to answer the following questions. What are the prerequisites, in terms of open …

The Size And Culturability Of Patient-Generated Sars-Cov-2 Aerosol, Joshua L. Santarpia, Vicki L. Herrera, Danielle N. Rivera, Shanna Ratnesar-Shumate, St. Patrick Reid, Daniel N. Ackerman, Paul W. Denton, Jacob W. S. Martens, Ying Fang, Nicholas Conoan, Michael V. Callahan, James V. Lawler, David Brett-Major, John Lowe

Journal Articles: Epidemiology

BACKGROUND: Aerosol transmission of COVID-19 is the subject of ongoing policy debate. Characterizing aerosol produced by people with COVID-19 is critical to understanding the role of aerosols in transmission.

OBJECTIVE: We investigated the presence of virus in size-fractioned aerosols from six COVID-19 patients admitted into mixed acuity wards in April of 2020.

METHODS: Size-fractionated aerosol samples and aerosol size distributions were collected from COVID-19 positive patients. Aerosol samples were analyzed for viral RNA, positive samples were cultured in Vero E6 cells. Serial RT-PCR of cells indicated samples where viral replication was likely occurring. Viral presence was also investigated by western …

Recommended Reporting Items For Epidemic Forecasting And Prediction Research: The Epiforge 2020 Guidelines, Simon Pollett, Michael A. Johansson, Nicholas G. Reich, David Brett-Major, Sara Y. Del Valle, Srinivasan Venkatramanan, Rachel Lowe, Travis Porco, Irina Maljkovic Berry, Alina Deshpande, Moritz U. G. Kraemer, David L. Blazes, Wirichada Pan-Ngum, Alessandro Vespigiani, Suzanne E. Mate, Sheetal P. Silal, Sasikiran Kandula, Rachel Sippy, Talia M. Quandelacy, Jeffrey J. Morgan, Jacob Ball, Lindsay C. Morton, Benjamin M. Althouse, Julie Pavlin, Wilbert Van Panhuis, Steven Riley, Matthew Biggerstaff, Cecile Viboud, Oliver Brady, Caitlin Rivers

Journal Articles: Epidemiology

BACKGROUND: The importance of infectious disease epidemic forecasting and prediction research is underscored by decades of communicable disease outbreaks, including COVID-19. Unlike other fields of medical research, such as clinical trials and systematic reviews, no reporting guidelines exist for reporting epidemic forecasting and prediction research despite their utility. We therefore developed the EPIFORGE checklist, a guideline for standardized reporting of epidemic forecasting research.

METHODS AND FINDINGS: We developed this checklist using a best-practice process for development of reporting guidelines, involving a Delphi process and broad consultation with an international panel of infectious disease modelers and model end users. The objectives …

Lying In Wait: The Resurgence Of Dengue Virus After The Zika Epidemic In Brazil, Anderson Fernandes Brito, Lais Ceschini Machado, Rachel J. Oidtman, Márcio Junio Lima Siconelli, Quan Minh Tran, Joseph R. Fauver, Rodrigo Dias De Oliveira Carvalho, Filipe Zimmer Dezordi, Mylena Ribeiro Pereira, Luiza Antunes De Castro-Jorge, Elaine Cristina Manini Minto, Luzia Márcia Romanholi Passos, Chaney C. Kalinich, Mary E. Petrone, Emma Allen, Guido Camargo España, Angkana T. Huang, Derek A. T. Cummings, Guy Baele, Rafael Freitas Oliveira Franca, Benedito Antônio Lopes Da Fonseca, T. Alex Perkins, Gabriel Luz Wallau, Nathan D. Grubaugh

Journal Articles: Epidemiology

After the Zika virus (ZIKV) epidemic in the Americas in 2016, both Zika and dengue incidence declined to record lows in many countries in 2017-2018, but in 2019 dengue resurged in Brazil, causing ~2.1 million cases. In this study we use epidemiological, climatological and genomic data to investigate dengue dynamics in recent years in Brazil. First, we estimate dengue virus force of infection (FOI) and model mosquito-borne transmission suitability since the early 2000s. Our estimates reveal that DENV transmission was low in 2017-2018, despite conditions being suitable for viral spread. Our study also shows a marked decline in dengue susceptibility …

Impact Of Extrinsic Incubation Temperature On Natural Selection During Zika Virus Infection Of Aedes Aegypti And Aedes Albopictus, Reyes A. Murrieta, Selene M. Garcia-Luna, Deedra J. Murrieta, Gareth Halladay, Michael C. Young, Joseph R. Fauver, Alex Gendernalik, James Weger-Lucarelli, Claudia Rückert, Gregory D. Ebel

Journal Articles: Epidemiology

Arthropod-borne viruses (arboviruses) require replication across a wide range of temperatures to perpetuate. While vertebrate hosts tend to maintain temperatures of approximately 37°C-40°C, arthropods are subject to ambient temperatures which can have a daily fluctuation of > 10°C. Temperatures impact vector competence, extrinsic incubation period, and mosquito survival unimodally, with optimal conditions occurring at some intermediate temperature. In addition, the mean and range of daily temperature fluctuations influence arbovirus perpetuation and vector competence. The impact of temperature on arbovirus genetic diversity during systemic mosquito infection, however, is poorly understood. Therefore, we determined how constant extrinsic incubation temperatures of 25°C, 28°C, 32°C, …

Mapping Heat Vulnerability Index Based On Different Urbanization Levels In Nebraska, Usa, Babak Jalalzadeh Fard, Rezaul Mahmood, Michael Hayes, Clinton Rowe, Azar M. Abadi, Martha Shulski, Sharon J. Medcalf, Rachel Lookadoo, Jesse E. Bell

Journal Articles: Epidemiology

Heatwaves cause excess mortality and physiological impacts on humans throughout the world, and climate change will intensify and increase the frequency of heat events. Many adaptation and mitigation studies use spatial distribution of highly vulnerable local populations to inform heat reduction and response plans. However, most available heat vulnerability studies focus on urban areas with high heat intensification by Urban Heat Islands (UHIs). Rural areas encompass different environmental and socioeconomic issues that require alternate analyses of vulnerability. We categorized Nebraska census tracts into four urbanization levels, then conducted factor analyses on each group and captured different patterns of socioeconomic vulnerabilities …

Viral Dynamics Of Acute Sars-Cov-2 Infection And Applications To Diagnostic And Public Health Strategies, Stephen M. Kissler, Joseph R. Fauver, Christina Mack, Scott W. Olesen, Caroline Tai, Kristin Y. Shiue, Chaney C. Kalinich, Sarah Jednak, Isabel M. Ott, Chantal B. F. Vogels, Jay Wohlgemuth, James Weisberger, John Difiori, Deverick J. Anderson, Jimmie Mancell, David D. Ho, Nathan D. Grubaugh, Yonatan H. Grad

Journal Articles: Epidemiology

SARS-CoV-2 infections are characterized by viral proliferation and clearance phases and can be followed by low-level persistent viral RNA shedding. The dynamics of viral RNA concentration, particularly in the early stages of infection, can inform clinical measures and interventions such as test-based screening. We used prospective longitudinal quantitative reverse transcription PCR testing to measure the viral RNA trajectories for 68 individuals during the resumption of the 2019-2020 National Basketball Association season. For 46 individuals with acute infections, we inferred the peak viral concentration and the duration of the viral proliferation and clearance phases. According to our mathematical model, we found …

Development And Validation Of A Psychometric Scale To Assess Attitude Towards Safe Abortions In Pakistan, Xaher Gul, Junaid-Ur-Rehman Siddiqui, Miraal Mavalvala, Waqas Hameed, Muhammad Ishaque

Community Health Sciences

Despite severe health and economic consequences that women face because of the negative attitude of healthcare providers towards safe abortion and post-abortion care (SA/PAC), no psychometric tool has yet been validated for assessing the attitude towards SA/PAC. Only a handful of studies have attempted to assess healthcare providers' attitude towards safe abortions in Pakistan. Therefore, this study aimed to develop and validate a psychometric scale to assess attitude towards safe abortions in Pakistan. The study collected data from 106 workers of an NGO that provides SA/PAC through an online and anonymous survey using the organisation's network. The study used factor …

Utility Of Repeat Testing For Covid-19: Laboratory Stewardship When The Stakes Are High, Lindsey M. Rearigh, Angela L. Hewlett, Paul D. Fey, M. Jana Broadhurst, David Brett-Major, Mark Rupp, Trevor Van Schooneveld

Journal Articles: Epidemiology

As the coronavirus disease 2019 (COVID-19) continues to circulate, testing strategies are of the utmost importance. Given national shortages of testing supplies, personal protective equipment, and other hospital resources, diagnostic stewardship is necessary to aid in resource management. We report the low utility of serial testing in a low-prevalence setting.

Covid-19 Vaccine Acceptance: We Need To Start Now, Krutika Kuppalli, David Brett-Major, Tara C. Smith

Journal Articles: Epidemiology

In this perspective, we discuss the importance of developing a vaccine to help curb transmission of severe acute respiratory syndrome coronavirus 2. The question remains: Once a safe and effective vaccine is developed, will the public be willing to get it? We present information from one of the first tracking polls to assess public attitudes and perceptions toward a possible coronavirus disease 2019 vaccine that suggests public hesitancy over a potential vaccine, concern regarding accelerating clinical trials, and unease over the vaccine approval process. Public health experts, government officials, advocates, and others in the scientific community should respect the signals …

Assessment Of A Program For Sars-Cov-2 Screening And Environmental Monitoring In An Urban Public School District, John Crowe, Andy T. Schnaubelt, Scott Schmidtbonne, Kathleen Angell, Julia Bai, Teresa Eske, Molly Nicklin, Catherine Pratt, Bailey White, Brodie Crotts-Hannibal, Nicholas Staffend, Vicki L. Herrera, Jeramie Cobb, Jennifer Conner, Julie Carstens, Jonell Tempero, Lori Bouda, Matthew Ray, James V. Lawler, Walter S. Campbell, John-Martin Lowe, Joshua L. Santarpia, Shannon Bartelt-Hunt, Michael R. Wiley, David Brett-Major, Cheryl Logan, M. Jana Broadhurst

Journal Articles: Epidemiology

Importance: Scalable programs for school-based SARS-CoV-2 testing and surveillance are needed to guide in-person learning practices and inform risk assessments in kindergarten through 12th grade settings.

Objectives: To characterize SARS-CoV-2 infections in staff and students in an urban public school setting and evaluate test-based strategies to support ongoing risk assessment and mitigation for kindergarten through 12th grade in-person learning.

Design, Setting, and Participants: This pilot quality improvement program engaged 3 schools in Omaha, Nebraska, for weekly saliva polymerase chain reaction testing of staff and students participating in in-person learning over a 5-week period from November 9 to December 11, 2020. …

The Relationship Between Social Vulnerability And Covid-19 Incidence Among Louisiana Census Tracts, Erin N. Biggs, Patrick M. Maloney, Ariane L. Rung, Edward S. Peters, William T. Robinson

Journal Articles: Epidemiology

Objective: To examine the association between the Centers for Disease Control and Prevention (CDC)'s Social Vulnerability Index (SVI) and COVID-19 incidence among Louisiana census tracts. Methods: An ecological study comparing the CDC SVI and census tract-level COVID-19 case counts was conducted. Choropleth maps were used to identify census tracts with high levels of both social vulnerability and COVID-19 incidence. Negative binomial regression with random intercepts was used to compare the relationship between overall CDC SVI percentile and its four sub-themes and COVID-19 incidence, adjusting for population density. Results: In a crude stratified analysis, all four CDC SVI sub-themes were significantly …