Epidemiology Commons^™

Cdc’S Core Elements To Promote Diagnostic Excellence, Daniel J Morgan, Hardeep Singh, Arjun Srinivasan, Andrea Bradford, L Clifford Mcdonald, Preeta K Kutty

Faculty, Staff and Students Publications

Nearly a decade after the National Academy of Medicine released the "Improving Diagnosis in Health Care" report, diagnostic errors remain common, often leading to physical, psychological, emotional, and financial harm. Despite a robust body of research on potential solutions and next steps, the translation of these efforts to patient care has been limited. Improvement initiatives are still narrowly focused on selective themes such as diagnostic stewardship, preventing overdiagnosis, and enhancing clinical reasoning without comprehensively addressing vulnerable systems and processes surrounding diagnosis. To close this implementation gap, the US Centers for Disease Control and Prevention (CDC) released the Core Elements of …

Interventions To Improve Timely Cancer Diagnosis: An Integrative Review, Mark L Graber, Bradford D Winters, Roni Matin, Rosann T Cholankeril, Daniel R Murphy, Hardeep Singh, Andrea Bradford

Faculty, Staff and Students Publications

Cancer will affect more than one in three U.S. residents in their lifetime, and although the diagnosis will be made efficiently in most of these cases, roughly one in five patients will experience a delayed or missed diagnosis. In this integrative review, we focus on missed opportunities in the diagnosis of breast, lung, and colorectal cancer in the ambulatory care environment. From a review of 493 publications, we summarize the current evidence regarding the contributing factors to missed or delayed cancer diagnosis in ambulatory care, as well as evidence to support possible strategies for intervention. Cancer diagnoses are made after …

Health Literacy, Health Perception, And Influencing Factors Among Immigrants, Canan Birimoglu Okuyan, Ebru Deveci, Fatma Karasu

Makara Journal of Health Research

Background: Individuals living in rural areas face several healthcare disadvantages, including limited access to medical facilities and specialists during emergencies. This study examines healthy lifestyle behaviors, health perceptions, and influencing factors among immigrants in a rural region of southern Türkiye.

Methods: This cross-sectional study involved immigrants registered at a family health center. Data were collected using a sociodemographic questionnaire, the Perception of Health Scale, and the Health Literacy Scale.

Results: Statistically significant differences in THLS-32 scores were found based on participants’ occupation, marital status, and education level (p < 0.05). A moderately positive correlation was observed between health literacy and health perception scores (p < 0.05).

Conclusions: Research on the relationship between …

Assessing Healthcare Students’ Self-Efficacy In Disaster Response: A Cross-Sectional Analysis, Aydın Şenol, Abdülkerim Adıyaman, Canan Birimoglu Okuyan

Makara Journal of Health Research

Background: Assessing healthcare students’ self-efficacy in disaster response is crucial for preparing them to effectively manage real-world disaster situations. This study aimed to assess the self-efficacy status of healthcare students in disaster response.

Methods: The data for this cross-sectional analysis were gathered from 498 healthcare students between November 18, 2023, and February 14, 2024, using an individual diagnostic form and the disaster-response self-efficacy (DRSE) scale. This scale is used to assess an individual’s self-efficacy in responding effectively to disasters, including on-site rescue competency, disaster psychological nursing competency, disaster role quality, and adaptation competency.

Results: The mean age …

Factors Related To The Incidence Of Hypertension Among People Above 18 Years At The Cibatu Public Health Center, Bekasi Regency, Verizka Azra, Yustiyani Yustiyani, Minsarnawati Minsarnawati, Catur Rosidati

Indonesian Journal of Public Health Nutrition (IJPHN)

Hypertension is a non-communicable disease that still becomes a public health issue. The percentage of hypertension cases at Cibatu Public Health Center increased from 31.7% in 2021 to 37% in 2022. Based on a preliminary study, hypertension was found to be the most common non-communicable disease at Cibatu Public Health Center. This study aimed to identify factors associated with the incidence of hypertension among individuals aged 18 years and older at Cibatu Public Health Center, Bekasi Regency, in 2024.We conducted a cross-sectional study in May involving 121 respondents. This study used standardized questionnaires that had been validated in previous research, …

Inequities In The Rehabilitation Process Of Musculoskeletal Injuries In Maine, Devon A. Grant

Thinking Matters Symposium

Since 2016, Maine’s population has grown as a result of migration and a welcoming of refugees. Changes in state demographics influence the population’s and individuals’ social determinants of health (SDOH) (ie., “where people live, learn, work, and play”) and health literacy (ie., a person’s ability to find, understand, and use information to inform health-related decisions). This project aims to identify the health inequities or disparities throughout Southern Maine in the care of injuries to the lower extremity, such as the knee or ankle, as well as explore factors that influence the healthcare outcomes of athletes in surrounding communities. This study …

Relation Of Persistent Organic Pollutant Exposure With Autism, Gender, Age, And Body Mass Index, Tekle Mitiku

Walden Dissertations and Doctoral Studies

Approximately one third (37%) of children in the United States are impaired with autism spectrum disorder (ASD) resulting in intellectual disability, and about 1 in 6 children in the United States has one or more developmental disabilities. The economic burden of ASD is estimated to be over $40 billion lost per year. The purpose of this study was to determine the relationship of polybrominated diphenyl ether derivatives (PBDEs) with ASD, age, gender, and body mass index (BMI). The conceptual framework of the study was based on the physiologically based pharmacokinetic theory that the body burden of PBDEs’ free radicals may …

Sexually Transmitted Infection (Sti) Incidence And Risk Factors Among People With Hiv (Pwh): Insights From A 13-Year Cohort Study In South Carolina, Salome-Joelle Gass, Shujie Chen, Jiajia Zhang Ph.D., Bankole Olatosi

Faculty Publications

The Ending the HIV Epidemic (EHE) initiative aims to reduce new HIV infections by 90% by 2030 in the United States (US). However, rising sexually transmitted infection (STI) rates exacerbate the bidirectional infection risk between HIV and STIs. Most research on STIs among people with HIV (PWH) has focused on high-risk groups, resulting in limited data on broader populations. This study addresses that gap by examining the incidence and risk factors for gonorrhea, chlamydia, and syphilis in a statewide cohort of PWH in South Carolina. Data from South Carolina’s HIV and STI surveillance systems were linked, and all PWH aged …

The Relationship Between Climate Change Awareness And Mental Health Among Adults In The United States, Stanley Nkemjika

Walden Dissertations and Doctoral Studies

Understanding the connection between climate change awareness and overall well-being is crucial, particularly regarding its impact on the environment and mental health. However, there is a need for more research on this topic, especially within the American context. The mental health implications of climate change are not yet fully understood, and there is a gap in the literature. This gap was addressed by exploring climate change awareness effects on mental health among U.S. adults. The social ecological model provided a framework to examine the impact of climate change awareness on mental health, considering individual, interpersonal, community, and societal factors. This …

Differences In Hepatocellular Carcinoma Incidence Trends Across Us Census Divisions, 2001 To 2021, Itunu O Sokale, Omar Rosales, Aaron P Thrift, Hashem B El-Serag, Elyse Burgess, Abiodun O Oluyomi

Faculty, Staff and Students Publications

Background/Objectives: Hepatocellular carcinoma (HCC) is a leading cause of cancer diagnoses and deaths in the United States. This study serves as an update on secular trends in national HCC incidence rates while exploring potential geographic and racial/ethnic differences across all nine US census divisions.

Methods: We analyzed HCC incidence data reported to the United States Cancer Statistics (USCS) database from 2001 to 2021 (excluding 2020 data, based on the Centers for Disease Control and Prevention's cautionary recommendations for COVID-19 pandemic data usage for trend analysis). We performed trend analyses of age-adjusted incidence rates in the US overall, by census …

Environmental Risk And Alpha-Gal Syndrome (Ags) In The Mid-Atlantic United States, Brandon D. Hollingsworth Ph.D., Margaret Wiener, Dana A. Giandimenico, Scott P. Commins, Ross M. Boyce

Faculty Publications

Alpha-gal syndrome (AGS), commonly referred to as the tick bite red meat allergy, has been reported worldwide with the number of suspected cases in the United States increasing from 24 in 2009 to over 34,000 in 2019. Within the US, AGS is associated with the bite of two tick species, Amblyomma americanum and Ixodes scapularis, and has particularly high incidence rates in the mid-Atlantic region. Because AGS is associated with tick bites, the risk of developing AGS is affected by the environment individuals visit. Despite this, as well as the numerous studies associating the environment with Am. americanum, …

The Havcr1-Centric Host Factor Network Drives Zika Virus Vertical Transmission, Wenzhe Yu, Jun Tao, Hongmin Cao, Wanshan Zheng, Beiang Zhang, Yue Zhang, Peiqun Xu, Yiwei Zhang, Xuan Liu, Yinan Wang, Han Cai, Gang Liu, Fan Liu, Haibin Wang, Haiyan Zhao, Indira U Mysorekar, Xiaoqian Hu, Bin Cao

Center on Aging Staff Publications

Zika virus (ZIKV) vertical transmission results in devastating congenital malformations and pregnancy complications; however, the specific receptor and host factors facilitating ZIKV maternal-fetal transmission remain elusive. Here, we employ a genome-wide CRISPR screening and identify multiple placenta-intrinsic factors modulating ZIKV infection. Our study unveils that hepatitis A virus cellular receptor 1 (HAVCR1) serves as a primary receptor governing ZIKV entry in placental trophoblasts. The GATA3-HAVCR1 axis regulates heterogeneous cell tropism in the placenta. Notably, placenta-specific Havcr1 deletion in mice significantly impairs ZIKV transplacental transmission and associated adverse pregnancy outcomes. Mechanistically, the immunoglobulin variable-like domain of HAVCR1 binds to ZIKV via …

Human Capital And Lifetime Income Gains Of Scaling-Up Small-Quantity Lipid Nutrient Supplements Among Children Under 2 Years: A Modelling Analysis, Nandita Perumal Phd, Goodrarz Danaei, Günther Fink, Mark Lambiris, Christopher R. Sudfeld

Faculty Publications

Undernutrition in early childhood is associated with adverse health and developmental outcomes later in life and remains a persistent global public health problem. Providing small-quantity lipid nutrient supplements (SQ-LNS) to children aged 6-24 months improves child growth and neurodevelopmental outcomes, but the potential long-term benefits to human capital have not been previously estimated. We estimated the potential returns to schooling and lifetime income attributable to increasing coverage of SQ-LNS for children < 2 years of age from 0% to 50% or 90% per five-year birth cohort in five countries (Bangladesh, Burkina Faso, Ethiopia, Pakistan, and Uganda) with a high burden of undernutrition. Random-effects meta-analyses were used to estimate the effect of SQ-LNS on child development using evidence from randomized controlled trials, and to estimate the returns to lifetime income as a function of change in development based on a de novo meta-analysis of observational economic studies. Gains in school years attributable to scaling-up SQ-LNS to 90% coverage ranged from 0.14 million school years (95% uncertainty interval [UI]: 0.064, …

Relationship Between Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, Inflammatory Biomarkers, And Hospital Length Of Stay Among Covid-19 Patients., Alice Aghamie Osuji

Walden Dissertations and Doctoral Studies

COVID-19 has put immense pressure on healthcare facilities, especially in managing patients with comorbidity. This study addressed the association between two important coinfections, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD), and their effect on hospital length of stay (LOS) among COVID-19 patients. The study also explored the predictive role of the inflammatory biomarker C-reactive protein (CRP) in prolonged hospitalization, also considering the influence of age and race. This study applied the Biopsychosocial Model and Chronic Care Model (CCM) to examine health outcomes and resource use. A retrospective cohort research design was used to examine medical records of …

The Intersecting Association Of Speaking A Non-Dominant Language And Lower Healthcare Access On Self-Reported Depression Among U.S. Adults: A Cross Sectional Study Using Nhanes Data (2015-March 2020), Vincenzo J. Cornacchione, Corey Linver

OHSU-PSU School of Public Health Annual Conference

Objective: This analytic study examined the joint and independent associations between language preferences and healthcare access on moderate to severe depression among non-institutionalized adults living in the U.S., using data from the 2015 to March 2020 National Health and Nutrition Examination Survey (NHANES).

Methods: In this cross-sectional study design, we analyzed a nationally representative data set comprised of 11,051 participants. Multivariable logistic regression models were used to estimate the joint and independent associations between our dual exposures and moderate to severe depression, adjusting for key demographic variables based on our theoretical framework. We created categorical measures of preferred language (speaking …

Primary Place To Go For Health Care And Its Association With Hpv Prevalence In Us Adults: Results From Nhanes 2013-2016, Amy L. Mcveety, Miyuki Sun

OHSU-PSU School of Public Health Annual Conference

Background: While access to health care is a known risk factor for many infectious diseases, including sexually transmitted infections, little research has investigated the relationship between access to primary care services and prevalent human papillomavirus (HPV) infection. Given HPV’s prevalence in the general population and lack of available treatments, it is necessary to understand possible risk factors to identify areas for intervention. This study uses primary place to go for health services as a proxy measure for access to care, in order to understand which sources of health care are serving patients with the highest prevalence of HPV infections and …

Association Between Arsenic And Other Heavy Metal Exposures Through Drinking Water And Food With Lung Function And Respiratory Symptoms: A Cross-Sectional Study, Sofia I. Chapela Lara, Seth O'Neal Md, Mph For The Cysticercosis Working Group In Peru

OHSU-PSU School of Public Health Annual Conference

Impaired lung function is a major health concern, particularly in children, as it increases the risk of chronic respiratory diseases and long-term morbidity. Environmental exposure to heavy metals (HMs) such as arsenic, lead, cadmium, and manganese has been associated with reduced lung function and respiratory symptoms. However, findings vary by exposure context and population, with limited research in pediatric populations and few studies evaluating the combined effects of multiple HMs. These exposures disproportionally affect marginalized rural communities, especially in low and middle-income countries with mining activities. This cross-sectional study investigated the association between exposure to As and other HMs through …

Association Of Plant-Based Dietary Patterns With Female Reproductive Cancer Incidence And Mortality: A Systematic Review, Esther L. Farley, Scott Moore, Gary A. Giovino, Darryl Somayaji

Campus Research Month

Healthy plant-based eating, a health-related behavior that nurses may promote, has been associated with a decrease in multiple types of cancer. However, the association of a healthy plant-based dietary pattern with decreased female reproductive cancers has not yet been established.

This review of the literature followed PRISMA guidelines to search for the relationship between a healthy plant-based dietary pattern and incidence of and mortality from a breast or gynecological cancer diagnosis. Databases searched for this review included PubMed, EMBASE, CINAHL, and Web of Science.

We identified 27 publications that met the qualifications for inclusion. Twelve studies covered mortality from breast, …

Social Support And Treatment Outcomes Among Multi-Drug Resistant Tuberculosis And Persons Living With Hiv In Nigeria, Abiodun Olusegun Hassan

Walden Dissertations and Doctoral Studies

An estimated 40% of people with tuberculosis (TB) are missed due to underdiagnosis, and among those previously treated TB cases, about a quarter develop drug-resistant TB in Nigeria. The emergence of multi-drug-resistant TB (MDR-TB) is stalling the effort towards TB’s control and eradication. Few studies have examined the impact of the psychosocial effect and support systems for TB, particularly for MDR-TB. In this quantitative, cross-sectional study, the predictive relationship between social support given to MDR-TB patients and their treatment outcomes was examined using secondary data of 594 MDR-TB cases enrolled between January 2018 and December 2021. The theoretical framework for …

Irreversible K-Threshold Number Ck(G) And Saturation Probability P[G] For Corona Product And Double Corona Product Graphs, Eric J. Moon, Soumya Bhoumik, Paul Flesher

SACAD: Scholarly Activities

We discuss the Irreversible k-conversion process for graphs, where a vertex becomes saturated and remains saturated indefinitely if at least k of its neighbors are saturated. We investigate sets S₀, which when initially saturated, lead to complete graph saturation. We are interested in the minimum |S₀| = C_k(G), called the k-threshold number. We consider the construction of the Corona Product Graphs (of C_n and K_p). Additionally, we extend our analysis by defining and exploring Double Corona Product Graphs (of C_n and K_p). Then we incorporate …