Epidemiology Commons^™

Breast Cancer Care In Canada And The United States: Ecological Comparisons Of Extremely Impoverished And Affluent Urban Neighborhoods, Kevin M. Gorey

Social Work Publications

This study examined the differential effect of extreme impoverishment on breast cancer care in urban Canada and the United States. Ontario and California registry-based samples diagnosed between 1998 and 2000 were followed until 2006. Extremely poor and affluent neighborhoods were compared. Poverty was associated with non-localized disease, surgical and radiation therapy (RT) waits, non-receipt of breast conserving surgery, RT and hormonal therapy, and shorter survival in California, but not in Ontario. Extremely poor Ontario women were consistently advantaged on care indices over their California counterparts. More inclusive health insurance coverage in Canada seems the most plausible explanation for such Canadian …

Income And Long-Term Breast Cancer Survival: Comparisons Of Vulnerable Urban Places In Ontario And California, Kevin M. Gorey

Social Work Publications

Effects of socioeconomic status on the long-term survival of 808 women with node-negative breast cancer in Canada and the United States were observed. Ontario and California samples diagnosed between 1988 and 1990 were followed until 2006. Socioeconomic data were taken from population censuses. Compared with their California counterparts, residents of low-income urban areas in Ontario experienced a significant 15-year survival advantage (RR = 1.66 [95% CI: 1.00, 2.76]). In these and other vulnerable, lower-middle- to working-class neighborhoods, significantly more Ontario residents gained access to adjuvant radiation therapy (RR = 1.75 [1.21, 2.53]) which seemed associated with better long-term survival (RR …

Physician Supply And Breast Cancer Survival, Kevin M. Gorey

Social Work Publications

BACKGROUND: This study tested the hypothesis that physician supply thresholds are associated with breast cancer survival in Ontario.

METHODS: The 5-year survival of 17,820 female breast cancer patients diagnosed between 1995 and 1997 was surveilled until 2003 for all-cause mortality. Physician supply densities in 1991 and 2001 were computed for 49 Ontario regions.

RESULTS: There were independent threshold effects for general practitioners (GP; 7.25 per 10,000) and obstetrician/gynecologists (OB/GYN; 6 per 100,000) at or above which women with breast cancer were more likely to survive for 5 years. The respective risk of living in areas undersupplied with OB/GYN and GP …

Subclinical Hyperthyroidism And Dementia: The Sao Paulo Ageing & Health Study (Spah), Paulo A. Lotufo

Paulo A Lotufo

Background: Several epidemiologic studies have shown a possible association between thyroid function and cognitive decline. Our aim was to evaluate the association of subclinical hyperthyroidism and dementia in a population sample of older people. Methods: A cross-sectional study - São Paulo Ageing & Health Study (SPAH) - in a population sample of low-income elderly people ≥ 65 years-old to evaluate presence of subclinical thyroid disease as a risk factor for dementia. Thyroid function was assessed using thyrotropic hormone and free-thyroxine as well as routine use of thyroid hormones or antithyroid medications. Cases of dementia were assessed using a harmonized one-phase …

Environmental Valuation: The Sum Of Specific Damages Approach, Philip E. Graves

PHILIP E GRAVES

There is no abstract for this book chapter.

Smoking During Pregnancy And Risk Of Abnormal Glucose Tolerance: A Prospective Cohort Study, Penelope Susan Pekow, Amy E. Haskins, Elizabeth R. Bertone-Johnson, Elena Carbone, Renee T. Fortner, Lisa Chasen-Tabe

Penelope Susan Pekow

Background: Disturbances in glucose metabolism during pregnancy are associated with negative sequalae for both mother and infant. The association between smoking and abnormal glucose tolerance (AGT) remains controversial. Therefore, the aim of this study was to examine the relationship between smoking prior to and during pregnancy and risk of AGT. Methods: We utilized data from a prospective cohort of 1,006 Hispanic (predominantly Puerto Rican) prenatal care patients in Western Massachusetts. Women reported pre- and early pregnancy smoking at recruitment (mean = 15 weeks) and mid pregnancy smoking at a second interview (mean = 28 weeks). AGT was defined as > 135 …

The Latina/O Mental Health Paradox Or Racial/Ethnic Disparities? Depression Among New Immigrants To The U.S, Sandra Iveth Ramirez

Open Access Theses & Dissertations

The Latino/a Mental Health Paradox states that the foreign-born immigrants have better mental health outcomes when compared with native-born groups of various ethno-racial backgrounds, with the gap in mental stress minimizing overtime. The objective of this study is to examine whether Latina/os immigrants suffer an ethno-racial disparity in mental health or if they have favorable mental health outcomes as predicted by the Paradox. Expanding on the Latina/o Mental Health Paradox, rather than comparing Latina/o immigrants with native-born, this study will compare depression among recently legalized Latina/os with recent legalized European immigrants.

Observer-Dependent Model For Analyzing Subjective Parameters In Epidemiology, Milad Zarei

Open Access Theses & Dissertations

Although medical technologies for preventing the contagion and spread of infectious diseases have improved steadily throughout the last century, new infectious diseases are still emerging and spreading swiftly. The modeling of infectious disease spread is crucial in addressing the lack of predictive ability in epidemiology. Managing the spread of infectious diseases requires processing quantitative epidemiological data and the ability to capture the dynamics of the infectious disease in order to provide a measure of control.

In this thesis, I have introducing cognitive biases in diseases spread modeling. For the first time, to the author's knowledge, the human subjective experience has …

Automated Detection Of Infectious Disease Outbreaks In Hospitals: A Retrospective Cohort Study, Susan S. Huang, Deborah S. Yokoe, John Stelling, Hilary Placzek, Martin Kulldorff, Ken Kleinman, Thomas F. O'Brien, Michael S. Calderwood, Johanna Vostok, Julie Dunn, Richard Platt

Public Health Department Faculty Publication Series

BACKGROUND:

Detection of outbreaks of hospital-acquired infections is often based on simple rules, such as the occurrence of three new cases of a single pathogen in two weeks on the same ward. These rules typically focus on only a few pathogens, and they do not account for the pathogens' underlying prevalence, the normal random variation in rates, and clusters that may occur beyond a single ward, such as those associated with specialty services. Ideally, outbreak detection programs should evaluate many pathogens, using a wide array of data sources.

METHODS AND FINDINGS:

We applied a space-time permutation scan statistic to microbiology …

The Mediating Role Of Psychological Distress In The Relationship Between Adverse Childhood Experiences And Adult Smoking, Tara Wynn Strine

Walden Dissertations and Doctoral Studies

While research has indicated that impaired mental health partially mediates the relationship between adverse childhood experiences (ACEs) and alcohol and illicit drug use, little research has examined potential mediators in the relationship between ACEs and smoking, the number one cause of preventable mortality in the United States. Accordingly, this study examined the potential mediating effect of psychological distress on the relationship between ACES and smoking using data from Wave II of the ACE Study, a cross-sectional study completed between June and October of 1997 on a sample of adult health maintenance organization members (N = 7,211). The theoretical underpinnings for …

Immigration And Obesity In African American Adults Residing In The United States, Julius N. Ade

Walden Dissertations and Doctoral Studies

Obesity increases risk for heart disease, hypertension and other chronic diseases, and it affects minority ethnic groups disproportionately. However, it is unknown if African American immigrant adults, an increasing segment of the population, are at higher risk for obesity than African American non-immigrant adults residing in the United States. This study examined the association of obesity and immigrant status by comparing African American immigrant adults now residing in the United States to the general population of African American adults. The socio-ecological model provided the conceptual framework for this study. This study used a cross-sectional quantitative self-administered web-based survey to collect …

Program Evaluation For Tdap Immunization Standing Orders In A Birthing Hospital, Helen Crean Taugher

Doctor of Nursing Practice (DNP) Projects

Newborn infants are vulnerable to pertussis infections. Although the Advisory Committee on Immunization Practices (ACIP) recommends that babies begin their diphtheria, tetanus and acellular pertussis (DTaP) immunization series at two months of age, the minimum age for administration of the vaccine is six weeks of age (Centers for Disease Control [CDC], 2008). Young infants are at risk for whooping cough infection transmitted from parents, siblings and care-givers during the pre-vaccination period in the first two months of life, particularly pertussis transmitted from their mothers. Since the licensure of adult/adolescent formulations of tetanus, diphtheria and acellular pertussis (Tdap) vaccine in 2005, …

The Effect Of Direct Contact On Public Attitudes Towards People Living With Human Immunodeficiency Virus (Hiv) And Acquired Immune Deficiency Syndrome (Aids) In Zimbabweans, Mavis Mashingaidze

Walden Dissertations and Doctoral Studies

Stigma surrounding HIV and AIDS poses a significant threat to the curtailing of the epidemic by acting as a barrier to HIV testing and disclosure of serostatus. Previous research in the United States found personal knowledge of someone with HIV/AIDS to be a predictor of lower levels of HIV/AIDS-related stigma. However, no study to date has examined this relationship in Zimbabweans. Allport's contact hypothesis was hypothesis was the theoretical frame used to assess the effect of direct contact on public attitudes towards people living with the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in Zimbabweans with the …

Clinical Recognition Of Obstructive Sleep Apnea In A Population-Based Sample, Mark R. Zellmer

Walden Dissertations and Doctoral Studies

Obstructive sleep apnea (OSA), a disorder in which the airway intermittently collapses and obstructs during sleep, is associated with increased cardiovascular and cerebrovascular morbidity and mortality, increased risk of motor vehicle accidents, metabolic syndrome, hypertension, and depression. Treatment of OSA attenuates or reverses many of these associated risks. However, most cases of OSA are unrecognized and untreated. The two most recent studies using 1990s data found that only 6.5 - 15.4% of OSA cases, depending on severity, are clinically recognized in mixed gender populations. Based on a conceptual framework of improved physician awareness of OSA, and reduced diagnostic access bias …

Risk Factors For Development Of High Blood Pressure And Obesity Among African American Adolescents, Monique Shanta White

Walden Dissertations and Doctoral Studies

Childhood obesity has reached epidemic proportions in the United States and has been linked to hypertension, especially among African American youth. Optimistic bias leads youth to underestimate their susceptibility to negative health outcomes. Public health officials want to reduce risk factors to result in significant long term reduction in cardiovascular disease. The purpose of this study was to explore adolescent behavior practices in a school district and prevalence of high blood pressure and obesity in that population. The health belief model guided the framework for this study. Research questions examined relationship between individual health risk practices and optimistic bias on …

Racial /Ethnic Disparities In Hypertension In United States Residents: A Cross-Sectional Study Of Potential Explanatory Covariates, Franklin I. Opara

Walden Dissertations and Doctoral Studies

Racial/ethnic disparities persist in hypertension (HTN) prevalence in the United States, and African Americans are disproportionately affected. The incidence is more than two-folds in African Americans compared to Caucasians, and mortality is highest among African Americans. Understanding the risk factors in HTN and how these factors vary across racial/ethnic groups is essential to reducing the mortality among African Americans. This study examined the prevalence of HTN among a sample non-institutionalized U.S. residents (N = 30,852), assessed racial/ethnic disparities and determined factors associated with racial/ethnic variance in HTN. A cross-sectional design was used to address these aims, utilizing the National Health …

Social Capital Variables As Predictors Of Hiv Risk-Taking Behaviors Among Sub-Saharan African Immigrants In The United States, Gbadebo Ogundiran Ogungbade

Walden Dissertations and Doctoral Studies

Vulnerable populations, including immigrants, are often at risk for human immunodeficiency virus (HIV) infection because of their risk-taking behaviors. This study investigated risk-taking behavior for HIV infection among Sub-Saharan African (SSA) immigrants in United States. Using social capital as a theoretical foundation, the study aimed to address the question, is there any association between social capital assets of educational opportunity, employment, and eligibility for social assistance and HIV risk-taking behavior, defined as condom use before sex (CUBS) among SSA immigrant in the U.S? Potential participants were recruited through religious and social organizations in a southwestern US state. The survey generated …

The Relationship Between Mosquito Abundance And Rice Field Density In The Republic Of Korea, Erin E. Richards, Penny Masuoka, David Brett-Major, Matthew Smith, Terry A. Klein, Heung Chul Kim, Assaf Anyamba, John Grieco

Journal Articles: Epidemiology

BACKGROUND: Japanese encephalitis virus (JEV), the causative agent of Japanese encephalitis (JE), is endemic to the Republic of Korea (ROK) where unvaccinated United States (U.S.) military Service members, civilians and family members are stationed. The primary vector of the JEV in the ROK is Culex tritaeniorhynchus. The ecological relationship between Culex spp. and rice fields has been studied extensively; rice fields have been shown to increase the prevalence of Cx. tritaeniorhynchus. This research was conducted to determine if the quantification of rice field land cover surrounding U.S. military installations in the ROK should be used as a parameter in a …

Malaria And Helminth Co-Infections In Outpatients Of Alaba Kulito Health Center, Southern Ethiopia: A Cross Sectional Study, Abraham Degarege, Abebe Animut, Mengistu Legesse, Berhanu Erko

Journal Articles: Epidemiology

BACKGROUND: Distribution of malaria and intestinal helminths is known to overlap in developing tropical countries of the world. Co-infections with helminth and malaria parasites cause a significant and additive problem against the host. The aim of this study was to asses the prevalence of malaria/helminth co-infection and the associated problems among febrile outpatients that attended Alaba Kulito Health Center, southern Ethiopia November and December 2007. A total of 1802 acute febrile patients were diagnosed for malaria. 458 Giemsa-stained thick and thin blood films were used for identification of Plasmodium species and Stool samples prepared using Kato-Katz technique were used to …

Recent Diarrhea Is Associated With Elevated Salivary Igg Responses To Cryptosporidium In Residents Of An Eastern Massachusetts Community, A. I. Egorov, L. M. Montuori Trimble, L. Ascolillo, H. D. Ward, Deborah A. Levy, R. D. Morris, E. N. Naumova, J. K. Griffiths

Journal Articles: Epidemiology

BACKGROUND: Serological data suggest that Cryptosporidium infections are common but underreported. The invasiveness of blood sampling limits the application of serology in epidemiological surveillance. We pilot-tested a non-invasive salivary anti-Cryptosporidium antibody assay in a community survey involving children and adults.

MATERIALS AND METHODS: Families with children were recruited in a Massachusetts community in July; symptoms data were collected at 3 monthly follow-up mail surveys. One saliva sample per person (n = 349) was collected via mail, with the last survey in October. Samples were analyzed for IgG and IgA responses to a recombinant C. hominis gp15 sporozoite protein using a …