Epidemiology Commons^™

Piloting Very Early Infant Diagnosis Of Hiv In Lesotho: Acceptability And Feasibility Among Mothers, Health Workers And Laboratory Personnel., Michelle M Gill, Lynne M Mofenson, Mamakhetha Phalatse, Vincent Tukei, Laura Guay, Matsepeli Nchephe

Epidemiology Faculty Publications

INTRODUCTION: Mortality associated with in-utero HIV infection rises rapidly within weeks after birth. Very early infant diagnosis of HIV (VEID)-testing within 2 weeks of birth-followed by immediate initiation of antiretroviral therapy has potential to avert mortality associated with in-utero transmission. However, our understanding of acceptability and feasibility of VEID is limited.

METHODS: VEID was piloted in an observational prospective cohort of HIV-positive pregnant women and their infants in 13 Lesotho health facilities. Between March-July 2016, semi-structured interviews were conducted with HIV-positive women attending 6-week or 14-week postnatal visits and health workers (HWs) in 8 study facilities in 3 districts as …

Sexually Transmitted Infections Among Hiv-Infected Individuals In The District Of Columbia And Estimated Hiv Transmission Risk: Data From The Dc Cohort, Jose Lucar, Rachel Hart, Nabil Rayeed, Arpi Terzian, Amy Weintrob, Amanda D. Castel, Debra A. Benator, Dc Cohort Executive Committee

Epidemiology Faculty Publications

Background

Washington, DC, has one of the highest rates of HIV infection in the United States. Sexual intercourse is the leading mode of HIV transmission, and sexually transmitted infections (STIs) are a risk factor for HIV acquisition and transmission.

Methods

We evaluated the incidence and demographic factors associated with chlamydia, gonorrhea, and syphilis among HIV-infected persons enrolled at 13 DC Cohort sites from 2011 to 2015. Using Poisson regression, we assessed covariates of risk for incident STIs. We also examined HIV viral loads (VLs) at the time of STI diagnosis as a proxy for HIV transmission risk.

Results

Six point …

Who's Vaping Now? Relationship Between Ever And Current E-Cigarette Use And Demographic, Social, Economic, Health Characteristic And Behavior Indicators, Tacheka M. Bailey

MUSC Theses and Dissertations

Scientific information about e-cigarettes is limited; thus, insufficient safety and efficacy research on e-cigarettes is one reason that the products have attracted controversy. Although the scientific, regulatory, and lay communities have been passionate in their responses to e-cigarettes, they are divided, with some advocating their use based on the harm reduction approach and others arguing against use based on the precautionary principle. The purpose of this cross-sectional research study was to examine the relationship between e-cigarette use (ever/past and current) and social, economic, and health behavior indicators. Flay and Petraitis’ Theory of Triadic Influence served as the theoretical foundation of …

Long-Term Health Impacts Of Cell Phone-Driven Radiofrequency Radiation Exposure In Humans, Ndukaku Omelu

Walden Dissertations and Doctoral Studies

Uncertainties still exist about the safety of cell phone use and the level of cell phone-driven radiation. The purpose of the current inquiry was to determine the long-term health impacts of cell phone-driven radiation via the use of cell phones. In this cross-sectional study, which was based on socio-ecological theory, secondary data from the 2012 National Health Interview Survey were analyzed to assess the difference in the prevalence of thyroid cancer, mouth/tongue/lip cancer, and heart disease between exposed and non-exposed/less exposed cell phone-driven radiation groups in the United States. Logistic regression was used to address three research questions. Findings initially …

Effect Of Lung Cancer Treatment On Health-Related Quality Of Life, Festus Frempong Dokyi

Walden Dissertations and Doctoral Studies

Advances in lung cancer treatment among older adults require a risk-benefit analysis for health professionals, patients, and family members to assess increased survival and health-related quality of life (HRQL). The purpose of this study was to assess the effect of lung cancer treatment with surgery or tumor ablation on HRQL domains. A lung cancer quality of life model guided the study. The research design was a quantitative ancillary study in which 70 participants were recruited from those who had already consented to undergo a randomized clinical trial of lung cancer treatment. Data consisted of repeated administrations (baseline, 1- and 3-months) …

Challenges Of Aging With The Hiv Virus And Comorbidities, Rommie Navylia Abele

Walden Dissertations and Doctoral Studies

Since the introduction of antiretroviral therapy, the survival rate of infected HIV patients has been on the rise with a predicted increase by 2030. The longer a person lives with the virus, the more prone to HIV-associated chronic diseases he or she becomes, but it is not clear whether these diseases are solely from aging with the virus or from long-term use of antiretroviral therapy. Scientists demonstrated that the introduction of antiretroviral therapy led to an increased life expectancy yet early onset of comorbidities; however, they failed to address the challenges that people 50 years old or older face, as …

Catheter-Associated Urinary Tract Infection In New York And North Carolina, Kehinde O. Abiodun

Walden Dissertations and Doctoral Studies

In the United States, many hospitalized patients with indwelling urinary catheters acquire catheter-associated urinary tract infections (CAUTI) during their hospital stay. CAUTI negatively affects peoples' health and quality of life and causes a financial burden to individuals and the nation. The purpose of this quantitative cross-sectional study was to explore the relationship between gender, age, and hospital types and CAUTI incidence in New York and North Carolina over a 3-year period. The theoretical framework of choice was the Donabedian model. Simple logistic regression and hierarchical multivariable logistic regression analysis were performed on archival data that was requested from Healthcare Cost …

Association Of Dietary Intake With Suicidal Ideation Or Suicide Attempts In Adolescents, Zenobia J. Bryant

Walden Dissertations and Doctoral Studies

Suicide is among the leading cause of adolescent deaths worldwide and thus a significant public health concern. Risk factors for suicidal behavior include drinking alcohol, smoking, and engaging in risky sexual behaviors. One area of concern is dietary patterns and their association with depressive symptoms and suicidal ideation. Bandura's social cognitive theory emphasizes the assumption that one can perform specific actions to bring about desired outcomes. The primary research questions for this quantitative, retrospective, cross-sectional study concerned whether there is a statistically significant interaction between fruit and vegetable intake and suicidal ideation or suicide attempts. Data from 71,776 adolescents in …

Uterine Corpus Malignancies In Appalachia Kentucky: Incidence, Survival And Related Health Disparities, Marian Symmes Johnson

Theses and Dissertations--Clinical Research Design

Uterine cancer is the nation’s most common gynecologic malignancy but is understudied in the geographically and socioeconomically diverse state of Kentucky (KY). This study assessed the frequency, distribution, and survival of uterine corpus malignancies in KY, and specifically the differences between Appalachia (AP) and non-Appalachia (NAP).

This study utilizes SEER and Kentucky Cancer Registries to study uterine corpus malignancy between January 1, 2000 and December 31, 2014. The analysis looks at incidence between diagnoses in AP and NAP. Evaluation criteria includes: tumor histology (Type I, Type II, sarcoma, and mixed uterine malignancy), age, race, smoking status, stage at diagnosis, insurance …

Temporal And Geospatial Trends Of Pediatric Cancer Incidence In Nebraska Over A 24-Year Period, Evi A. Farazi, Shinobu Watanabe-Galloway, L. Westman, B. Rettig, P. Hunt, R. Cammack, John W. Sparks, Don W. Coulter

Journal Articles: Epidemiology

BACKGROUND: Data from the Surveillance, Epidemiology, and End Results (SEER) revealed that the incidence of pediatric cancer in Nebraska exceeded the national average during 2009-2013. Further investigation could help understand these patterns.

METHODS: This retrospective cohort study investigated pediatric cancer (0-19 years old) age adjusted incidence rates (AAR) in Nebraska using the Nebraska Cancer Registry. SEER AARs were also calculated as a proxy for pediatric cancer incidence in the United States (1990-2013) and compared to the Nebraska data. Geographic Information System (GIS) mapping was also used to display the spatial distribution of cancer in Nebraska at the county level. Finally, …

Comparative Effectiveness Of Conventional And Novel Sampling Methods For The Recruitment Of Sexual Minority Identified Women, Sarah M. Piperato

Theses and Dissertations

Sexual minority identified (SMI) women have an amplified risk for risky health behaviors and chronic health conditions. Current research on mechanisms related to health disparities in SMI women is limited. Research targeting SMI women has relied on small, convenience samples to address health disparities. Due to the nature of this population, probability sampling methods are ineffective and inefficient and cost prohibitive. The purpose of this dissertation was threefold. First, we examined the current state of literature to gain insight on prevalent sampling strategies used to access SMI women for health-related research. Second, we compared the efficacy of two sampling strategies, …

Estimating The Prevalence Of Hepatitis C In Sub-Saharan Africa, William Howard Adams

Dissertations

Hepatitis C (HCV) is a virus transmitted via contact with contaminated products such as razor-blades or by engaging in high-risk activities (i.e., such as sexual or injecting drug-use activities). Today, there are an estimated 115 million people world-wide living with HCV. Despite recent advancements in antiviral treatments that can ameliorate (or even cure) HCV, treatment remains laborious and costly and is often unavailable in resource-poor areas such as Sub-Saharan Africa (SSA). The primary aim of this study was to estimate the prevalence of HCV in SSA.

A meta-analysis was conducted on the HCV epidemic in SSA. A literature search for …

The Effectiveness Of Interventions And Bundles For Central Line-Associated Bloodstream Infections In The Neonatal Intensive Care Unit, Mohamad Alhamwi

Honors Undergraduate Theses

Introduction: Central Line-Associated Bloodstream Infections (CLABSIs) are a major cause of increased mortality, morbidity and healthcare costs in neonatal intensive care units (NICUs) patients. Despite CDC's efforts to reduce infection rates, patients often suffer consequences. The objective of this study is to perform a systematic review of strategies utilized in the neonatal population and evaluate them with the current CDC's guidelines to assess the effectiveness of bundles in preventing CLABSI in NICUs.

Methods: A systematic literature search was conducted using CINAHL Plus with Text, Cochrane Database of Systematic Reviews and MEDLINE from January 2008 up to 2018. There were multiple …

Socioeconomic Status And Cigarette Expenditure Among Us Households: Results From 2010 To 2015 Consumer Expenditure Survey, Mohammad Siahpush, Evi A. Farazi, Shannon I. Maloney, Danae Dinkel, Minh N. Nguyen, Gopal K. Singh

Journal Articles: Epidemiology

OBJECTIVES: To examine (1) the association between household socioeconomic status (SES) and whether a household spends money on cigarettes and (2) socioeconomic variations in proportion of total household expenditure spent on cigarettes among smoking households.

METHODS: We pooled data from six consecutive years, 2010-2015, of the Consumer Expenditure Interview Survey. The interviews involved a structured questionnaire about household income, demographics and expenditures including expenditure on cigarettes. Households that reported cigarette expenditure in the previous 3 months were distinguished as smoking households. SES indicators were household poverty status, education and occupation of the head of household. Logistic regression was used to …

Catching Chances: The Movement To Be On The Ground And Research Ready Before An Outbreak, David Brett-Major, James V. Lawler

Journal Articles: Epidemiology

After more than 28,000 Ebola virus disease cases and at least 11,000 deaths in West Africa during the 2014⁻2016 epidemic, the world remains without a licensed vaccine or therapeutic broadly available and demonstrated to alleviate suffering. This deficiency has been felt acutely in the two, short, following years with two Ebola virus outbreaks in the Democratic Republic of Congo (DRC), and a Marburg virus outbreak in Uganda. Despite billions of U.S. dollars invested in developing medical countermeasures for filoviruses in the antecedent decades, resulting in an array of preventative, diagnostic, and therapeutic products, none are available on commercial shelves. This …

Xenosurveillance Reflects Traditional Sampling Techniques For The Identification Of Human Pathogens: A Comparative Study In West Africa, Joseph R. Fauver, James Weger-Lucarelli, Lawrence S. Fakoli, Kpehe Bolay, Fatorma K. Bolay, Joseph W. Diclaro, Doug E. Brackney, Brian D. Foy, Mark D. Stenglein, Gregory D. Ebel

Journal Articles: Epidemiology

BACKGROUND: Novel surveillance strategies are needed to detect the rapid and continuous emergence of infectious disease agents. Ideally, new sampling strategies should be simple to implement, technologically uncomplicated, and applicable to areas where emergence events are known to occur. To this end, xenosurveillance is a technique that makes use of blood collected by hematophagous arthropods to monitor and identify vertebrate pathogens. Mosquitoes are largely ubiquitous animals that often exist in sizable populations. As well, many domestic or peridomestic species of mosquitoes will preferentially take blood-meals from humans, making them a unique and largely untapped reservoir to collect human blood.

METHODOLOGY/PRINCIPAL …

Coming Out Of "Retirement"-Predictors Of Driving Resumption Among Older Drivers, Kendra Ratnapradipa, Jing Wang, Marla Berg-Weger, Mario Schootman

Journal Articles: Epidemiology

Background and Objectives: Predictors and consequences of driving cessation in older adults have been studied extensively. This study sought to establish the extent to which former drivers resume driving and identify associated factors.

Research Design and Methods: Descriptive analysis of the 2011-2015 National Health and Aging Trends Study data (Round 1:

Results: Among drivers who stopped driving during the study, 17%-28% resumed driving. Age, vehicle ownership, stroke, hospitalization, memory, and perceived transportation barriers were associated with resumption in regression analysis. In multilevel analysis stratified by baseline driving status, poor word recall (OR = 0.62; 95% CI = 0.40, 0.95) and …

Education Plan To Empower Wound Care Nurses For Evidence-Based Practice, Patricia Stevenson

Walden Dissertations and Doctoral Studies

Non-healing wounds can claim thousands of lives and costs billions of dollars each year, and nurse-led wound clinics are becoming necessary to fill a gap in care for patients with wounds. Even among certified wound nurses using evidence-based clinical protocols, key considerations of care are being missed. Therefore, this project was focused on developing and validating a new biofilm education module for certified or certification eligible wound care nurses. The aim of the module was to boost clinical assessment knowledge and improve patient outcomes. Benners skill acquisition model informed the development of this project. The design of the project also …

Health Care Facilities As A Predictor Of Breast Cancer Survival Rates, Elizabeth Natalie Webster

Walden Dissertations and Doctoral Studies

The disparity between survival rates for Black and White women with breast cancer is well documented and has been examined in terms socioeconomics, environment, tumor type, and genetics. However, there is little examination of the role of health care facilities in cancer disparities. Health care facilities are representative of societal norms and beliefs that include location, quality of care, finance, policies, and staffing; therefore, they are a proxy for social justice and social change. The purpose of this study was to examine correlations between health care facility type; social determinants of cancer such as poverty, culture, and social justice; and …

Association Between Androgen Deprivation Therapy For Prostate Cancer And Alzheimer's Disease, Gina Giannantoni-Ibelli

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is the most common progressive, neurodegenerative disease and form of dementia. The hallmarks of AD are extracellular accumulation of amyloid beta protein, resulting in neuritic, senile plaques and intracellular accumulation of tau protein. AD mainly arises from imbalance of amyloid beta protein production and its clearance in the brain. Testosterone modulates production of amyloid beta protein by decreasing its accumulation. Prostate cancer remains a substantial public health challenge in the United States. While androgen deprivation therapy (ADT) is an effective treatment for prostate cancer, it may be associated with cognitive impairment due to decreased levels of testosterone. …