Epidemiology Commons^™

Effects Of Medications With Anticholinergic Properties And Opioids On Cognitive Function And Neural Volumetric Changes In Elderly Australians, Malinee Neelamegam

USF Tampa Graduate Theses and Dissertations

Introduction: Multiple comorbidities are common among older adults. Pharmaceutical interventions are the most common form of medical management of the multiple health conditions that the older adult population faces. Almost 90% of adults aged 65 years and above take at least one prescription medication. Polypharmacy (5 medication or more) occurs with 50% of the older adult population. Most medications used to treat common ailments affecting the geriatric population have anticholinergic properties. These medications are known to cause a range of side effects from peripheral effects to central nervous system effects. These adverse effects are of particular concern in the older …

Effects Of Alcohol Consumption On Nephropathy, Retinopathy, And Neuropathy In Type 1 Diabetes In The Diabetes Control And Complications Trial (Dcct), Victoria Trapani

GW Research Days 2016 - 2020

Effects of long-term alcohol consumption have not been well studied in populations with diabetes, though regular alcohol consumption is common among American adults and it is estimated that at least 10% of Americans have diabetes. Individuals living with diabetes who are heavy alcohol consumers may be at heightened risk for diabetic complications. Using the well-phenotyped Diabetes Control and Complications Trial (DCCT) cohort of 1,246 adult subjects with type 1 diabetes, a secondary analysis was conducted to determine if relationships exist between alcohol consumption and nephropathy, retinopathy, and neuropathy at baseline, follow-up year 5, and DCCT closeout. This secondary analysis found …

A Triple Threat: Alcohol Use Disorders In The Presence Of Comorbid Chronic Pain Conditions And Depressive Disorders In The Collaborative Psychiatric Epidemiology Surveys, 2001-2003, Chelsea Boyd, Sean Cleary, Scott Quinlan, Debra Bernat

GW Research Days 2016 - 2020

Background: Frequently patients with chronic pain conditions have comorbid depressive disorders. The relationship between the diagnoses is often bidirectional, with the effects of one condition exacerbating the effects of the other. Alcohol use disorders (AUD) are also independently associated with both conditions. This study aims to determine the prevalence of alcohol use disorders among patients with comorbid chronic pain conditions and depressive disorders in a nationally representative sample of US adults and ascertain the characteristics of patients with all three diagnoses.

Methods: This cross-sectional analysis utilizes data from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003. The sample includes respondents who …

Interaction Between Intellectual Disability And Cerebral Palsy On The Co-Occurrence Of Autism Spectrum Disorder And Epilepsy, Prarthana Hareesh, Sean D. Cleary

GW Research Days 2016 - 2020

Intellectual disability (ID) is possibly a reason for the higher co-occurrence of Autism Spectrum Disorder (ASD) in children with epilepsy. Cerebral Palsy (CP) has also been found to co-occur with ASD (6.9%-hypotonic, 18.4%-spastic subtype) and with epilepsy (41%), but it is unclear if the co-occurrence of ASD and epilepsy varies by the presence of both, ID and CP. The purpose of this study to evaluate effect modification of CP and ID on ASD-epilepsy co-occurrence.

Cancer Management In Kenya - Awareness And The Struggles Patients Face To Access Treatment, Care & Support, Ashley Nmoh

Independent Study Project (ISP) Collection

The amount of cancer cases in Africa, and Kenya specifically, are rising at an alarming rate. This study was conducted to determine the challenges that patients with cancer in Kenya face to access treatment, care and support. Thirty-nine cancer patients were interviewed and thirty cancer patients filled out a questionnaire about their experiences of having cancer in Kenya. In addition, twenty key informants were interviewed including doctors, caregivers, cancer NGO executives, a researcher, a psychologist, a National Health Insurance Fund official and a director from the Ministry of Health. A breast cancer awareness survey was also administered to fifty-nine women …

Identifying Predictors Of Racial Disparity In Treatment And Mortality Among Patients Diagnosed With Breast Cancer In South Carolina, Oluwole Adeyemi Babatunde

Theses and Dissertations

Introduction: Despite a lower incidence of breast cancer (BrCA) among Black women in the U.S. compared to White women, Black women experience consistently higher mortality rates. The aims of this study were 1) to assess the relationship between race and diagnosis-to-treatment times 2) to assess racial disparity in mortality among Black and White BrCA patients in SC and 3) assessment of the validity of the Mortality-to- incidence ration (MIR) as a proxy for survival and geospatial investigation of racial disparity among breast cancer (BrCA) patients.

Methods: Breast cancer cases diagnosed between 2002-2010 were obtained retrospectively from the SC Central Cancer …

Adverse Birth Outcomes Among Women With Physical Disabilities: A Retrospective Cohort Study In South Carolina, Iffat Nahar

Theses and Dissertations

Motherhood is precious in women’s lives. Among women, ages 21-64, 12.5% are living with a disabling condition, according to the Disability Status report: SC 2008. Although childbearing among women with disabilities is increasing, there are limited publications about the pregnancy outcomes. The objective of this study is to document the adverse neonatal outcomes of the pregnancies and to evaluate if early prenatal care is a protective factor for low birthweight and prematurity among the women with physical disabilities. This study used a retrospective cohort study design, with data from linked hospital discharge records and vital records (birth certificates) for all …

Tobacco Smoking And Dementia In A Kentucky Cohort: A Competing Risk Analysis, Erin L. Abner, Peter T. Nelson, Gregory A. Jicha, Gregory E. Cooper, David W. Fardo, Frederick A. Schmitt, Richard J. Kryscio

Epidemiology and Environmental Health Faculty Publications

Tobacco smoking was examined as a risk for dementia and neuropathological burden in 531 initially cognitively normal older adults followed longitudinally at the University of Kentucky’s Alzheimer’s Disease Center. The cohort was followed for an average of 11.5 years; 111 (20.9%) participants were diagnosed with dementia, while 242 (45.6%) died without dementia. At baseline, 49 (9.2%) participants reported current smoking (median pack-years = 47.3) and 231 (43.5%) former smoking (median pack-years = 24.5). The hazard ratio (HR) for dementia for former smokers versus never smokers based on the Cox model was 1.64 (95% CI: 1.09, 2.46), while the HR for …

Respiratory Infections And Risk For Development Of Narcolepsy: Analysis Of The Truven Health Marketscan Database (2008 To 2010) With Additional Assessment Of Incidence And Prevalence, Darren Scheer

USF Tampa Graduate Theses and Dissertations

Background and Significance: Narcolepsy is a chronic neurological disorder. These patients experience various psychiatric and physical comorbid diseases and mortality at an increased rate compared to the general population. Additionally, patients with narcolepsy experience approximately a doubling of various annual healthcare related facility visits, transactions, and costs comparatively. Narcolepsy with cataplexy is generally believed to be more prevalent than narcolepsy without cataplexy. However, incidence and prevalence estimates of narcolepsy (with or without cataplexy) vary widely with few large epidemiological studies conducted worldwide and none in the U.S evaluating these proportions in both children and adults utilizing a large health care …

2018-2019 Acip Immunization Updates: Highlights For Pharmacists, Laressa Bethishou, Luma Munjy, Jeff Goad

Pharmacy Faculty Articles and Research

"Vaccinations have significantly reduced the burden of infectious diseases, preventing almost 6 million deaths worldwide.^1,2 In the United States, vaccines have led to a decrease in incidence of vaccine-preventable illness, mortality, and disease sequelae.³ Despite the proven benefit of vaccines, misinformation and failure to vaccinate has led to outbreaks of vaccine-preventable diseases. As of December 29, 2018, 372 cases of measles (from 17 outbreaks) and 2251 cases of mumps were reported in the United States in 2018.^4,5 These outbreaks support the need for continued education of patients and active immunization by pharmacists."

Shingrix Revaccination And Vaccination In Vulnerable Populations, Laressa Bethishou, Luma Munjy, John Andraos

Pharmacy Faculty Articles and Research

"Herpes zoster, also known as shingles, is a painful cutaneous eruption that develops following the reactivation of the varicella zoster virus (VZV), the same virus that causes chickenpox.¹ About 1 in 3 people in the United States will develop shingles, with an estimated 1 million cases occurring annually. Anyone with a history of chickenpox is at risk for shingles, but the risk increases with age and in patients who are immunocompromised.²"

A Woman With A Lung Infiltrate And Brain Abscesses: Case Discussion From The University Of Louisville Hospital, Veronica Corcino, Viswanathan Nagarajan, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Assessment Of Pneumonia Severity Indices As Mortality Predictors, Connor L. English, Thomas Chandler, Brian E. Guinn, Stephen P. Furmanek, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

BACKGROUND

The leading cause of infectious disease death in the United States is community-acquired pneumonia (CAP). Several pneumonia severity indices exist and are widely used as tools to assist physicians regarding site of care based on risk of death. However, limited data exists that discerns which of the most commonly used severity scores is the best predictor of mortality across multiple time points. The objective of this study is to determine the best mortality predictor at different time points between four of the most commonly used pneumonia severity scores.

METHODS

This was a secondary analysis of a prospective, multicenter, population-based, …

A Man With Acute Severe Pneumonia: Case Discussion From The University Of Louisville Hospital, Viswanathan Nagarajan, Srinivas R. Dontineni, Veronica Corcino, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Current And Future Antiviral Medications To Treat Influenza: Mechanisms Of Action, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Pilot Study On The Efficiency Of Water-Only Decontamination For Firefighters’ Turnout Gear, Anthony Calvillo, Erin N. Haynes, Jeff Burkle, Kenny Schroeder, Angelo Calvillo, Julie Reese, Tiina Reponen

Epidemiology and Environmental Health Faculty Publications

Firefighters are exposed to toxic environments upon entering burning structures. Many structures contain synthetic materials which release toxic chemicals when on fire. These chemicals can enter the body through multiple routes of exposure, including inhalation and skin absorption. Thus, according to the fire departments included in this study, firefighters now conduct on-site decontamination procedures to remove hazardous chemicals, including polycyclic aromatic hydrocarbons from the surface of firefighter turnout gear. Several methods are being practiced at the local level, including decontamination with soap and water, and decontamination with water alone. The water-only decontamination method requires less time and supplies yet has …

An Iterative Process For Training Design And Implementation Increased Health Workers' Knowledge For Taking Nutrition Behavior Change To Scale, Wendy Gonzalez, Anabelle Bonvecchio Arenas, Armando García-Guerra, Mireya Vilar-Compte, Alejandría Villa De La Vega, Laura Quezada, Cynthia Rosas, Ana Lilia Lozada-Tequeanes, Amira Hernández

Department of Public Health Scholarship and Creative Works

The shortage of skilled, motivated, and well-supported health workers is a major barrier to scaling up nutrition interventions and services. Objective: The objective of this study is to describe the process for developing and implementing a training of health personnel for the delivery of the Integrated Strategy for Attention to Nutrition (EsIAN), an evidence-based strategy for promoting infant and young child feeding through primary health care in Mexico. The specific objective is to provide a case study and highlight challenges, as well as elements to successfully mitigate these, and discuss potential applications of findings beyond the Mexican context. Methods: The …

Prevalence, Patterns And Factors Associated With Hypertensive Crises In Mulago Hospital Emergency Department; A Cross-Sectional Study, Martha Sajatovic

Faculty Scholarship

Background: Hypertension is increasing in sub-Saharan Africa (SSA) and it’s the single most important modifiable stroke risk factor, yet it’s control is not routinely emphasized. The prevalence, pattern and factors associated with hypertensive urgencies and emergencies in Uganda is not well established. A cross-sectional study, was conducted between November 2015 and February 2016, using a complete clinical examination and pre-tested standardized questionnaire subjects were enrolled. The prevalence of hypertensive crises and associations of demographic and clinical factors determined using logistic regression. Results: The prevalence of hypertensive crises was 5.1%, (203/4000) of all admissions at the medical section of the accident …

Development Of A Real-Time Pcr Assay For Pneumocystis Jirovecii On The Luminex Aries® Platform, Subathra Marimuthu, Kuldeep Ghosh, Leslie A Wolf

The University of Louisville Journal of Respiratory Infections

Pneumocystis pneumonia (PCP) is an opportunistic infection caused by the fungus Pneumocystis jirovecii. Infection with P. jirovecii can result in serious illness in patients with a weakened immune system, and can lead to death if it is not properly diagnosed and treated. Direct detection of P. jirovecii in lower respiratory tract specimens such as bronchoalveolar lavage (BAL) is preferred for rapid diagnosis, a laboratory service currently not available locally. We report here the development of a diagnostic real-time Polymerase Chain Reaction (PCR) assay using BAL specimens to detect P. jirovecii. By targeting the multi-copy mitochondrial large subunit ribosomal …

Influence Of Decentralization And Type Of Patient On Loss To Follow-Up Among Multidrug-Resistant Tuberculosis Patients In Indonesia From 2014 To 2015, Noerfitri Noerfitri, R. Sutiawan, Tri Yunis Miko Wahyono, Pratiwi Ayuningtyas Hartono

Kesmas

Drug-resistant tuberculosis (TB) patients have a greater risk of loss to follow-up (LTFU) than drug-sensitive TB patients, due to their longer treatment duration. This study aimed to determine the influence of decentralization and patient type on LTFU among multidrug-resistant TB (MDR-TB) patients in Indonesia. A retrospective cohort study was conducted at all MDR-TB treatment healthcare facilities in Indonesia from 014 to 2015. Using total sampling technique, 961 patients were examined and sampled. Of these patients, 86.03% were decentralized. Patients were classified into types as follows: 35.17% were “relapse” patients, 5.52% were “new,” 13.94% were classified as “after LTFU” patients, 23.10% …