Epidemiology Commons^™

Disparities In Colorectal Cancer: Measuring Spatial Accessibility, Screening, And Surveillance Outcomes In South Carolina, Michele J. Josey

Theses and Dissertations

The purpose of this dissertation project is to add to the growing literature about the multi-faceted aspects of colorectal cancer (CRC) prevention and related disparities. We focused on the spatial distribution of facilities performing screening services to identify areas that underutilize colonoscopy screening. Next, we examined how the food and physical activity environment affects precursors of CRC by considering plausible pathways. Finally, we explored if access to health insurance reduced the racial disparity of receiving a timely surveillance colonoscopy after a CRC diagnosis.

We utilized the SC Ambulatory Surgery Discharge Database, an all-payer, population-based outpatient dataset with colonoscopy records from …

Statin Prescription For Patients With Atherosclerotic Cardiovascular Disease From National Survey Data, Kristina Vatcheva, Vicente Aparicio, Ayesha Araya, Eduardo Gonzalez, Susan T. Laing

School of Mathematical & Statistical Sciences Faculty Publications

Despite strong evidence for the use of statins for patients with atherosclerotic cardiovascular disease (ASCVD), statin prescription is still suboptimal. We aimed to determine the rates and factors that influence statin prescription using national survey data. This is a cross-sectional retrospective study on 8,468 patients with clinical ASCVD who were drawn from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey from years 2011 to 2015. Survey-weighted analysis was conducted to estimate weighted prevalence and odds ratios for statin prescription. There was a significant increase in statin prescription from the years 2011 to 2015. Nevertheless, …

Effect Of Heart Rate Variability Biofeedback On Sleep, Joshua Mercadel

Theses and Dissertations

Healthy amounts of sleep is vital for normal human functions such as daily learning, memory, emotional state and cardiovascular function. Studies conducted previously have shown sleep deprivation to be associated with increases in sympathetic activity contributing to autonomic nervous system (ANS) dysregulation. HRV biofeedback (HRVB) training induces HRV coherence, a condition that maximizes HRV and facilitates autonomic and cardiorespiratory homeostasis. This randomized, controlled, intervention trial will test the hypothesis that HRVB can improve HRV coherence and increase overall sleep quality. Patients are randomized to previously established HRVB or sham protocols (n=40 each, total planned enrollment N=80). Each participant completes a …

Exploring Breast Cancer Care Variation In Coc-Accredited Facilities, Sarah Grace Barron

Theses and Dissertations

INTRODUCTION: While improvements have been made in reducing breast cancer incidence and mortality over the past twenty years, disparities in breast cancer mortality remain. Understanding systematic differences in breast cancer treatment and quality of care remain at the epicenter of understanding breast cancer disparities. Needle biopsy is a less invasive and less expensive diagnostic test for breast cancer (as compared to excisional biopsy) and permits diagnosis while avoiding unnecessary surgery. This study was conducted to 1) examine how the National Quality Forum (NQF)-endorsed needle biopsy utilization measure varies geographically (i.e. state and region) and 2) determine the patient- and/or health …

Association Between Snps In The Vitamin D Binding Protein, Vitamin D Status, And Aggressive Prostate Cancer By Race, Diana Diaz

Theses and Dissertations

Prostate cancer incidence and mortality have been decreasing in recent years, but it remains the most commonly diagnosed cancer among men. Racial disparities exist in prostate cancer with African Americans (AAs) having notably higher rates of incidence and mortality, lower survival rates, and are more likely to be diagnosed with a highergrade cancer compared to European Americans (EAs). Genome-wide association studies have revealed several single nucleotide polymorphisms (SNPs) within the vitamin Drelated GC gene that may be associated with prostate cancer aggressiveness. In addition to SNPs, previous research has suggested that low levels of 25-hydroxyvitamin D (25(OH)D) may be related …

Role Of Heart Rate Variability Biofeedback In Cognitive Performance, Chronic Pain, And Related Symptoms, James P. Winstead

Theses and Dissertations

Over-modulation of the sympathetic nervous system and reduced heart rate variability (HRV) are commonly overlooked components of pain, poor cognition (decreased attention, recall, and cognitive processing), depression, stress, and fatigue. HRV Biofeedback (HRVB) training induces HRV coherence to balance the autonomic system. Paced breathing (~6 breaths/minute) increases HRV coherence. This randomized, controlled intervention trial tested the hypothesis that HRVB would improve HRV coherence, pain (severity, interference, and catastrophizing), cognitive performance, and reduce depressive, stress, and fatigue symptoms and pain medication use in veterans. Participants were randomized to previously established HRVB or control protocols. Each participant completed a Baseline Assessment, 6 …

Prevalence Trends Of Victimization Among High School Students By Race, Ethnicity, And Gender – Yrbss 2009-2017, Carlos Avalos

Theses and Dissertations

Introduction: Students who are victimized at school are more likely to report mental health, behavioral, and academic problems. Bullying and electronic bullying are types of victimization that are prevalent in US schools, with prevalence varying by race and ethnicity, gender, and age. Additionally, due to increases in bias-based harassment (such as being targeted due to race, ethnicity, or religious beliefs) in the country over the last few years, it is of interest to see how victimization behaviors in schools may have changed from 2015 to 2017.

Objective: To analyze trends of overall bullying, school bullying, electronic bullying, and other forms …

Disparities In Non-Small Cell Lung Cancer In The United States: An Examination Of Treatment, Survival, And Access To Care, Cassie Lewis Odahowski

Theses and Dissertations

Lung cancer is the leading cause of cancer-related deaths in the United States with a 5-year survival rate of only 18%. Differences in access to care and treatment utilization may play a role in observed survival disparities among rural patient populations. This dissertation aimed to examine rural disparities in all-cause and lung-cancer specific survival, time to treatment initiation, and utilization of surgical treatment among non-small cell lung cancer cases.

We utilized comprehensive cancer registry data from the Surveillance, Epidemiology, and End Results program linked with Medicare billing claims (SEER-Medicare) for non-small cell lung cancer (NSCLC) patients diagnosed between 2003-2011. We …

Increasing Actual And Perceived Burden Of Tick-Borne Disease In Maine, Robert P. Smith Md Mph, Carol A. Mccarthy Md, Susan P. Elias Phd

Journal of Maine Medical Center

Introduction: The burden of tick-borne disease (TBD) in Maine has steadily increased since the first case of Lyme disease was reported in the late 1980s. The emergence of five different agents of TBD in Maine has been challenging and confusing for clinicians and the public.

Methods: We reviewed the ecology of emerging of tick -borne disease, then reviewed risk factors for tick bites and tick-borne disease in Maine. We then compared the burden of TBD versus community-acquired comparison infections in terms of hospitalizations, deaths, and media attention.

Results and Discussion: In Maine, risk of exposure to bites from the vector …

Determinan Kejadian Kejang Demam Pada Balita Di Rumah Sakit Ibu Dan Anak Budhi Mulia Pekanbaru, Zulmeliza Rasyid, Dian Kusuma Astuti, Christine Vita Gloria Purba

Jurnal Epidemiologi Kesehatan Indonesia

Kejang demam adalah bangkitan kejang yang dapat terjadi pada anak berumur 6 bulan sampai 5 tahun yang mengalami kenaikan suhu tubuh (suhu diatas 380C) yang tidak disebabkan oleh proses intracranial. Di Rumah Sakit Ibu dan Anak Budhi Mulia angka kejadian kejang demam pada balita tahun 2017 berjumlah 98 kasus dengan proporsi kasus yaitu 34,03%. Tujuan penelitian ini untuk menggambarkan dan mengetahui determinan kejadian kejang demam pada balita di RSIA Budhi Mulia Pekanbaru tahun 2015-2017. Desain Penelitian adalahcase control. Populasi sebanyak 1.119 orang dengan besar sampel sebanyak 144 dengan perbandingan 1:1 di mana 72 untuk kasus dan 72 untuk kontrol. Teknik …

Determinan Yang Meningkatkan Risiko Terinfeksi Hiv Pada Wargabinaan Lembaga Pemasyarakatan Dan Rumah Tahanan Di Indonesia: Studi Tinjauan Pustaka 2007-2017, Mondastri Korib Sudaryo

Jurnal Epidemiologi Kesehatan Indonesia

Wargabinaan pemasyarakatan (WBP) diduga berisiko terinfeksi HIV selama tinggal di lembaga pemasyarakatan (lapas) dan rumah tahanan (rutan) akibat menyuntik narkotika dan perilaku berisiko lainnya. Studi ini bertujuan mengetahui determinan yang meningkatkan faktor risiko terinfeksi HIV di kalangan WBP di lapas/rutan di Indonesia. Rancangan studi adalah tinjauan pustaka sistematik (systematic literature review) yang merangkum dan membandingkan hasil studi dari 12 artikel yang diterbitkan sejak 2007 2017 di jurnal nasional/internasional berbahasa Inggris/Indonesia mengenai karakteristik dan determinan infeksi HIV pada populasi WBP yang tinggal di lapas/rutan di Indonesia. Karakteristik demografis WBP: umumnya laki laki; usia rata-rata 30 tahun (rentang: 21-51 tahun); sebagian besar <=SMU; setengahnya menikah. Prevalensi HIV di kalangan WBP di beberapa lapas: 10%-56%. Tiga survei nasional tahun 2011, 2013, 2015 menunjukkanprevalence rate antara 1,2% – 3%. Proporsi perilaku berisiko: menyuntik narkotika (antara 5% - 66%), berbagi jarum suntik (28%-47%), kontak seksual tidak aman dengan sesama WBP (2%-13%), atau dengan WPS (96%), pakai tattoo (2%-56%), atau tindik (5%-13%), minum alkohol (47%). Dari 3 survey yang sama tingkat prevalensi Sifilis antara 2,1%– 5%. Determinan/faktor risiko terinfeksi HIV: menggunakan narkotika suntik (OR antara 11,4 - 104,8), pakai tatoo (OR: 1,7 -2,4), pakai tindik (OR = 4,4), seks tidak aman (OR=1,9), terinfeksi Sifilis (OR=4,2). Faktor-faktor penting yang meningkatkan risiko terinfeksi HIV di kalangan WBP di lapas/rutan adalah penggunaan narkotika suntik, berbagi jarum suntik tidak steril, kontak seksual dengan sesama WBP &/ WPS, terinfeksi Sifilis dan memakai tato/tindik.

Karakteristik Pasien Tuberkulosis Lost To Follow Up Dari Empat Rs Di Kota Bandung, Azizah Muthiah, Noormarina Indraswari, Budi Sujatmiko

Jurnal Epidemiologi Kesehatan Indonesia

Jumlah kasus tuberkulosis (TB) yang tidak terlaporkan dan tidak terdeteksi di Indonesia sebelum pelaksanaan sistem pengawasan TB nasional pada tahun 2017 mencapai 47% dari total kasus, termasuk di dalamnya kasus TBlost to follow up atau hilang dari pengamatan. Pasien yang termasuk dalam kelompok ini akan meningkatkan risiko perburukan klinis, kambuh, gagal pengobatan, dan menjadi resistan terhadap obat, selain itu mereka juga akan mejadi sumber penularan di masyarakat. Tujuan penelitian ini yaitu untuk mengetahui karakteristik pasien rawat jalan TB yang hilang dari pengamatan dari empat rumah sakit terpilih di Kota Bandung. Penelitian ini menggunakan studi deskriptif dengan rancangan potong lintang. Sampel …

Gender And Hypertantion (Data Analysis Of The Indonesia Basic Health Research 2007), Krisnawati Bantas, Dwi Gayatri

Jurnal Epidemiologi Kesehatan Indonesia

The objective of this study was to examine whether there was a gender difference in the occurrence of hypertension in Indonesian people, after controlling for individual and environment factors. Data were ob tained from the Indonesia Basic Health Research 2007 and a cross sectional design was used. Samples consisted of 13.262 men and women age 15 years or more. A multilevel logistic regression was used to ana lyze the data. There was a statistically significant association between gender and hypertension. Women were less likely to have hypertension than men (OR 0.86 P value < 0.0033). There was an interaction between variable of gender and variable of age. It suggested that the probability of having hypertension in women and men was varied by the strata of age. In the strata of age more than 60 years, women were more likely to have hypertension than men (OR 1.25, P value 0.0065); in strata of age 30-59 years, there was no difference of having hypertension between women and men (P value > 0.05); in strata of age <30 years, women were less likely to have hypertension than men (OR 0.67 Pvalue 0.0000). Among women, there was an increased of having hypertension with age. Age of e” 60 years was the highest risk of having hypertension. Among men, there was an increased of having hypertension with age, but at in the age of e” 60 years the increased risk of having hypertension was not as high as in women.

Hubungan Diabetes Melitus Dengan Hipertensi Pada Populasi Obesitas Di Indonesia (Analisis Data Ifls-5 Tahun 2014), Crysti Mei Manik, Sudarto Ronoatmodjo

Jurnal Epidemiologi Kesehatan Indonesia

Prevalensi obes di dunia tinggi. Data 2016 menunjukkan bahwa prevalensi obes meningkat 3 kali lipat yakni lebih dari 650 juta orang. Penderita diabetes melitus (DM) dan hipertensi banyak ditemukan pada populasi obes dan hal ini kemungkinan menunjukkan bahwa ada hubungan antara DM dengan hipertensi pada populasi obes. Di Indonesia prevalensi obes adalah 15.4%, DM 6.9% dan hipertensi 26.5%. Penelitian ini bertujuan melihat apakah ada hubungan DM dengan hipertensi pada populasi obes di Indonesia dengan menggunakan dataThe Indonesian Family Life Survey kelima(IFLS-5) Tahun 2014. Desain penelitian adalah cross sectional dengan jumlah sampel 712 orang dan analisis data menggunakan Cox regression.Dari 712 …

Epidemiologi Deskriptif Kematian Ibu Di Kabupaten Serang Tahun 2017, Suyanti Suyanti, Tri Yunis Miko Wahyono

Jurnal Epidemiologi Kesehatan Indonesia

Angka Kematian Ibu (AKI) merupakan indikator kesejahteraan masyarakat suatu negara. Sasaran RPJMN 2015-2019 di Indonesia AKI ditargetkan menjadi 306 pada tahun 2019. AKI di Kabupaten Serang tahun 2017 adalah 195/100.000 KH, atau 58 kasus dengan jumlah kelahiran hidup sebanyak 29.787 jiwa. Dari 58 kasus kematian ibu, 14 orang persalinan ditolong dukun (24,14%). Tujuan penelitian ini adalah eksplorasi deskriptif epidemiologi kematian ibu di Kabupaten Serang tahun 2017. Penelitian ini menggunakan studicase seriespada 58 kasus kematian ibu hasil dari AMP (Audit Maternal Perinatal). Lokasi penelitian di 24 puskesmas wilayah Dinas Kesehatan Kabupaten Serang. Kematian ibu di Kabupaten Serang tahun 2017 berdasarkan tiga …

Evolutionary Dynamics Of Influenza Type B In The Presence Of Vaccination: An Ecological Study, Lindsey J. Fiedler

USF Tampa Graduate Theses and Dissertations

Understanding the evolutionary dynamics of influenza type B in human hosts is a public health concern as we strive to minimize the disease burden in seasonal epidemics. Vaccination is considered the best defense against contracting influenza, and everyone over the age of 6 months is advised to get vaccinated before each season. The effect that vaccine-acquired immunity has on the evolution of influenza B remains unclear. In the U.S., vaccine-uptake is irregular across the states, and the differing coverages present an opportunity to study how vaccination influences viral evolution. This thesis analyzes the evolutionary patterns of influenza B in the …

Dietary Inflammatory Index, Dietary Non-Enzymatic Antioxidant Capacity, And Colorectal And Breast Cancer Risk(Mcc-Spain Study), Mireia Obón-Santacana, Dora Romaguera, Esther Gracia-Lavedan, Amaia Molinuevo, Esther Molina-Montes, Nitin Shivappa, James R. Hébert, Adonia Tardón, Gemma Castaño-Vinyals, Ferran Moratalla, Elisabet Guinó, Rafael Marcos-Gragera, Mikel Azpiri Leire Gil, Rocío Olmedo-Requena, Macarena Lozano-Lorca, Juan Alguacil, Tania Fernández-Villa, Vicente Martín, Antonio J. Molina, María Ederra, Beatriz Perez, Nuria Aragonés, Adela Castello, José Mª Huerta, Trinidad Dierssen-Sotos, Ana Molina-Barceló, Marina Pollán, Manolis Kogevinas, Victor Moreno, Pilar Amiano

Faculty Publications

Inflammation and antioxidant capacity have been associated with colorectal and breast cancer. We computed the dietary inflammatory index (DII®), and the total dietary non-enzymatic antioxidant capacity (NEAC) and associated them with colorectal and breast cancer risk in the population-based multi case-control study in Spain (MCC-Spain). We included 1852 colorectal cancer and 1567 breast cancer cases, and 3447 and 1486 population controls, respectively. DII score and NEAC were derived using data from a semi-quantitative validated food frequency questionnaire. Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for energy-adjusted DII (E-DII), and a score …

Dietary Inflammatory Index, Dietary Non-Enzymatic Antioxidant Capacity, And Colorectal And Breast Cancer Risk (Mcc-Spain Study), Mireia Obon-Santacana, Dora Romaguera, Esther Gracia-Lavedan, Amaia Molinuevo, Esther Molina-Montes, Nitin Shivappa, James R. Hébert, Adonina Tardon, Gemma Castano-Vinyals, Ferran Moratalla, Elisabet Guino, Rafael Marcos-Gragera, Mikel Azpiri, Leire Gil, Rocio Olmedo-Requena, Macarena Lozano-Lorca, Juan Alguacil, Tania Fernandez-Villa, Vicente Martin, Antonio J. Molina, Maria Ederra, Conchi Moreno-Iribas, Beatriz Perez, Nuria Aragones

Faculty Publications

Inflammation and antioxidant capacity have been associated with colorectal and breast cancer. We computed the dietary inflammatory index (DII^®), and the total dietary non-enzymatic antioxidant capacity (NEAC) and associated them with colorectal and breast cancer risk in the population-based multi case-control study in Spain (MCC-Spain). We included 1852 colorectal cancer and 1567 breast cancer cases, and 3447 and 1486 population controls, respectively. DII score and NEAC were derived using data from a semi-quantitative validated food frequency questionnaire. Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for energy-adjusted DII (E-DII), and …

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 the …

An Integrative Cross-Omics Analysis Of Dna Methylation Sites Of Glucose And Insulin Homeostasis, Jun Liu, Elena Carnero-Montoro, Jenny Van Dongen, Samantha Lent, Ivana Nedeljkovic, Symen Ligthart, Pei-Chien Tsai, Tiphaine C. Martin, Pooja R. Mandaviya, Rick Jansen, Marjolein J. Peters, Liesbeth Duijts, Vincent W. V. Jaddoe, Henning Tiemeier, Janine F. Felix, Gonneke Willemsen, Eco J. C. De Geus, Audrey Y. Chu, Daniel Levy, Shih-Jen Hwang, Jan Bressler, Rahul Gondalia, Elias L. Salfati, Christian Herder, Bertha A. Hidalgo, Toshiko Tanaka, Ann Zenobia Moore, Rozenn N. Lemaitre, Min A. Jhun, Jennifer A. Smith, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Despite existing reports on differential DNA methylation in type 2 diabetes (T2D) and obesity, our understanding of its functional relevance remains limited. Here we show the effect of differential methylation in the early phases of T2D pathology by a blood-based epigenome-wide association study of 4808 non-diabetic Europeans in the discovery phase and 11,750 individuals in the replication. We identify CpGs in LETM1, RBM20, IRS2, MAN2A2 and the 1q25.3 region associated with fasting insulin, and in FCRL6, SLAMF1, APOBEC3H and the 15q26.1 region with fasting glucose. In silico cross-omics analyses highlight the role of differential methylation …