Perceptions Of The Health Care System As Mediators In The Association Between Experiences Of Discrimination, Communication From Providers, And Gaps In Mammography, Hannah Cohen-Cline

Articles, Abstracts, and Reports

No abstract provided.

High-Resolution Geospatial Database: National Criteria-Air-Pollutant Concentrations In The Contiguous U.S., 2016–2020, Tianjun Lu, Sun-Young Kim, Julian D. Marshall

Epidemiology and Environmental Health Faculty Publications

Concentration estimates for ambient air pollution are used widely in fields such as environmental epidemiology, health impact assessment, urban planning, environmental equity and sustainability. This study builds on previous efforts by developing an updated high-resolution geospatial database of population-weighted annual-average concentrations for six criteria air pollutants (PM_2.5, PM₁₀, CO, NO₂, SO₂, O₃) across the contiguous U.S. during a five-year period (2016–2020). We developed Land Use Regression (LUR) models within a partial-least-squares–universal kriging framework by incorporating several land use, geospatial and satellite–based predictor variables. The LUR models were validated using conventional …

Delayed And Misdiagnosed Endometriosis, Teresa Doyle

Nursing | Senior Theses

Aim: This research investigates whether targeted education can improve the early diagnosis of endometriosis, a chronic condition affecting around 10% of women of reproductive age. Unfortunately, endometriosis is often misdiagnosed, delaying treatment, prolonging discomfort, and lowering quality of life. Healthcare practitioners' knowledge gap is addressed by this study, which examines whether organized training promotes awareness and diagnostic accuracy. This research proposal evaluates an educational intervention developed to improve gynecological experts' knowledge and diagnostic skills. The main research issue is whether the intervention reduces misdiagnosis and improves patient outcomes. A quasi-experimental design will examine participants' knowledge and diagnosis accuracy before and …

App Assisted Depression Self-Management In Integrated Primary Care: A Pilot Study Exploring Patient And Provider Experiences, David J. Johnson, Margaret R. Emerson, Danae Dinkel, Robbin Thomas, Shinobu Watanabe-Galloway, Maria S. Mickles, Carli Culjat

Journal Articles: Epidemiology

The integrated primary care (IPC) setting is currently the de facto institution for accessing mental healthcare among underserved populations. However, many barriers exist for these populations when seeking regular and adequate mental healthcare, including provider availability and transportation challenges. This study piloted the incorporation of mindLAMP, a mHealth app, into IPC treatment to offer a low-resource intervention designed to improve and expand access to mental healthcare for underserved patients between face-to-face visits. This study gathered data from a sample of both behavioral health providers and patients (N = 6) in IPC settings to pilot the use of the mindLAMP app …

Machine Learning Models For Pancreatic Cancer Survival Prediction: A Multi-Model Analysis Across Stages And Treatments Using The Surveillance, Epidemiology, And End Results (Seer) Database, Aditya Chakraborty, Mohan D. Pant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: Pancreatic cancer is among the most lethal malignancies, with poor prognosis and limited survival despite treatment advances. Accurate survival modeling is critical for prognostication and clinical decision-making. This study had three primary aims: (1) to determine the best-fitting survival distribution among patients diagnosed and deceased from pancreatic cancer across stages and treatment types; (2) to construct and compare predictive risk classification models; and (3) to evaluate survival probabilities using parametric, semi-parametric, non-parametric, machine learning, and deep learning methods for Stage IV patients receiving both chemotherapy and radiation. Methods: Using data from the SEER database, parametric models (Generalized Extreme Value, …

Changes In Cancer Diagnosis And Survival In The United States During The Covid-19 Pandemic, Justin T. Burus

Theses and Dissertations--Epidemiology and Biostatistics

The COVID-19 Pandemic led to global societal disruptions as political leaders and public health authorities attempted to control the spread of the newly discovered SARS- CoV-2 virus. While these measures were designed to lessen morbidity and mortality from a novel pathogen, their impact was also felt in many other, often unintended ways. The purpose of this dissertation is to use cancer surveillance research methods to examine the association between COVID-19 Pandemic-related disruptions and changes in the normal diagnosis and care of cancer in the United States.

The first two studies of this dissertation analyzed reductions in cancer diagnoses in the …

Enhancing Public Health Surveillance: Development And Validation Of Machine Learning Models For Suspected Opioid Overdose Detection In Emergency Medical Services Data, Peter J. Rock

Theses and Dissertations--Clinical and Translational Science

The ongoing opioid overdose crisis in the United States requires timely and accurate surveillance systems to inform public health responses. Traditional public health surveillance methods rely on hospital discharge data and death certificates, which suffer from significant reporting delays and miss cases where patients refuse hospital transportation. Emergency Medical Services (EMS) data presents a promising alternative with advantages in timeliness and case ascertainment but lacks validated definitions for suspected opioid overdose (SOO).

This dissertation addresses this critical gap through the development, validation, and fairness assessment of machine learning models with natural language processing (ML-NLP) for identifying SOOs in EMS data. …

The Incidence Of Postmenopausal Breast Cancer In Relation To Occupational Exposure To Textile Fibers And Dusts In Montreal, Canada, 2008-2011, Maymouna Myriam Ka, France Labrèche, Mark S. Goldberg, Vikki Ho

Études primaires

Objective To estimate the associations between occupational exposure to textile fibers/dusts, and incidence of postmenopausal invasive breast cancer.

Methods

A population-based case-control study conducted in Montreal (2008 − 2011) identified hospital cases (N = 695) and population controls (N = 608) from the electoral list. Occupational hygienists examined participants’ occupations and tasks, and attributed exposures to several textile fibers. For all tumors and according to biomolecular subtypes, odds ratios (OR) and 95% confidence intervals (95%CI) were estimated using logistic regression models with different exposure indices, adjusting for potential confounders.

Results

Ever exposure to cotton dust was associated with an increased …

Occupational Exposure To Combustion By-Products And Breast Cancer Risk In Postmenopausal Women, Kahlila Paul-Cole, France Labrèche, Mark S. Goldberg, Sydney Westra, Vikki Ho

Études primaires

Objective

To estimate the association between lifetime occupational exposure to select combustion by-products and postmenopausal breast cancer (BC) risk.

Materials and Methods

Data from a population-based case-control study among postmenopausal women residing in Montréal, Quebec were used. Cases included 661 women aged between 47 and 75 yr, diagnosed with incident malignant BC between 2008 and 2011. Controls comprised 587 women randomly selected from the Quebec Electoral List, frequency-matched to cases by 5-year age groups. Information on risk factors and lifetime occupational histories was collected by interview. Two industrial hygienists used job histories to assign exposure to 293 agents, including 6 …

An Epidemiological Study Of Finger, Hand, And Wrist Injuries In The Department Of Air Force And Us Workers, Melody Kay Gwilliam

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

An Epidemiological Study of Finger, Hand, and Wrist Injuries in the Department of Air Force and US workers

Melody Gwilliam

Background and Objectives: Fingers, hands, and wrists (FHW) are the leading injured body parts in work-related injuries in the United States (U.S.) and in the U.S. Department of the Air Force (DAF). There has been limited research on risk factors for FHW injuries. Workers across all industries are at risk for these injuries. The objectives of these studies are to 1) describe and compare FHW injuries among enlisted, officer, and civilian U.S. Department of the Air Force (DAF) …

Association Of Non-Communicable Diseases With Severe Covid-19 Among People Living With And Without Diagnosed Hiv/Aids In New York State, Ravi Kumar Balu

Electronic Theses & Dissertations (2024 - present)

Background: People living with diagnosed HIV (PLWDH) have a higher chance of co-infections and co-morbidities than the general population. When SARS-CoV-2 was first reported in China in December 2019 and later declared a pandemic, it was speculated that PLWDH might be more prone to SARS-CoV-2 infection and severe disease outcomes given their increased vulnerability to other respiratory infections like influenza, pneumococcal pneumonia and tuberculosis. However, several facets of COVID-19 disease in PLWDH are incompletely understood, including whether non-communicable diseases (NCDs) are strong risk factors for severe disease outcomes and death as they are in the general population.

Methods: The data …

Real-World Clinical And Cost Effectiveness Of Osteoporotic Treatments In Men, Yu Ren

Open Access Dissertations

Osteoporosis is a condition characterized by the loss of bone mass, which increases the risk of fractures. In 2017-2018, the age-adjusted prevalence of osteoporosis among adults aged 50 and over was 12.6%, with 19.6% in women and 4.4% in men. Untreated osteoporosis can lead to a cycle of recurrent fractures that severely impact quality of life and place significant emotional, physical, and financial strain on patients, families, and healthcare resources. Approximately 50% of women and 20% of men will experience at least one fracture in their lifetime. In the United States, an estimated 1.5 million osteoporotic fractures occur each year, …

Evaluating The Early Impact Of Ab 617: Air Pollution, Health Disparities, And Environmental Justice In California, Cherry Cheuk Lam Cheung, Adam Eckerd

School of Public Service Faculty Publications

This study evaluates the initial effectiveness of California’s Assembly Bill 617 (AB 617), enacted to address air pollution impacts in communities designated as environmental justice priorities, a policy approach that has recently been touted as a successful start. These claims of initial success stand in contrast to much of the research on remediation of environmental justice, particularly with respect to air pollution. Despite well-documented disparities in air pollution exposure and its health impacts among racial-ethnic minorities, previous policy efforts to mitigate these effects have had, at best, marginal effects. AB 617 mandates local air districts and the California Air Resources …

Comparison Of Dynamic Mode Decomposition With Other Data-Driven Models For Lung Cancer Incidence Rate Prediction, L. Raymond Guo, Jifu Tan, M. Courtney Hughes

Faculty Articles, Papers, and Other Scholarship

Introduction: Public health data analysis is critical to understanding disease trends. Existing analysis methods struggle with the complexity of public health data, which includes both location and time factors. Machine learning offers powerful tools but can be computationally expensive and require specialized knowledge. Dynamic mode decomposition (DMD) is an alternative that offers efficient analysis with fewer resources. This study explores applying DMD in public health using lung cancer data and compares it with other machine learning models.

Methods: We analyzed lung cancer incidence data (2000–2021) from 1,013 US counties. Machine learning models (random forest, gradient boosting machine, support vector machine) …

Multidisciplinary Lethal Means Safety Counseling Design And Implementation: Training And Identifying Barriers In A Children's Hospital, Cassandra L. Stegall, Brendon Carnell, Jaime M. Golden, Rupa Kapoor, John H. Fanton, Paul C. Mullan, Alexandra P. Leader

Department of Pediatrics Faculty Publications

Background

Access to lethal means contributes significantly to suicide completion. Lethal means safety counseling (LMSC) is an injury prevention strategy to limit access to firearms, medications, and other means of injury. Not previously evaluated in the trauma setting, this study aims to design and implement a standardized LMSC protocol for pediatric patient discharge education in emergency (ED), trauma, and inpatient psychiatry settings.

Methods

A single-center quality improvement study at an academic pediatric urban tertiary Level-one trauma center was performed from July 2023 to February 2024. Protocol was implemented for pediatric patients discharged from three departments: ED, surgery trauma service, and …

Predicting Mental Health Disparities Using Machine Learning For African Americans In Southeastern Virginia, Ismail El Moudden, Michael C. Bittner, Matvey V. Karpov, Isaac O. Osunmakinde, Akosua Acheamponmaa, Breshell J. Nevels, Mamadou T. Mbaye, Tonya L. Fields, Karthiga Jordan, Messaoud Bahoura

Department of Obstetrics & Gynecology Faculty Publications

This study examined mental health disparities among African Americans using AI and machine learning for outcome prediction. Analyzing data from African American adults (18–85) in Southeastern Virginia (2016–2020), we found Mood Affective Disorders were most prevalent (41.66%), followed by Schizophrenia Spectrum and Other Psychotic Disorders. Females predominantly experienced mood disorders, with patient ages typically ranging from late thirties to mid-forties. Medicare coverage was notably high among schizophrenia patients, while emergency admissions and comorbidities significantly impacted total healthcare charges. Machine learning models, including gradient boosting, random forest, neural networks, logistic regression, and Naive Bayes, were validated through 100 repeated 5-fold cross-validations. …

Gambaran Putus Obat Berdasarkan Sosial-Demografi Pada Penderita Tuberkulosis Di Indonesia Tahun 2023: Cross-Sectional Study, Anindya Oktaria Yudhanti, Arina Syahida Hurva Radisan Saf, Benita Riska, Enita Fransiska Tamba

Jurnal Epidemiologi Kesehatan Indonesia

Introduction: Tuberculosis is an infectious disease that spreads through the air. Based on data at the international and national levels, there has been an increase. Most pulmonary TB patients are cured with consecutive antibiotic treatment for 6-9 months, but there are still patients who eventually drop out of treatment. This could be a challenge in achieving the international tuberculosis elimination target of 2035 and the national target of 2030. Methods: This study analyzed the socio-demographic distribution and dropout analysis of Tuberculosis patients in Indonesia in 2023 based on SKI data with a cross-sectional study type. Results: The incidence of drug …

Association Between Rurality And Race/Ethnicity And Pediatric Cancer Early Mortality: A Population-Based Cohort Study Using Seer Data From 2000 To 2021, Kiersten Preuss, Emma Hymel, Melissa Acquazzino, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

BACKGROUND: Pediatric cancer mortality rates have steadily declined since 2009, but over a thousand deaths still occur annually. While existing research highlights the effects of race/ethnicity and rurality on overall survival, few studies have specifically analyzed these factors in relation to early mortality, defined as death within 12 months of diagnosis.

PROCEDURE: This study utilized SEER Research Plus Limited-Field Data (2000-2021) to examine the association between race/ethnicity, rurality, and early mortality in pediatric cancer patients. A cohort of 138,648 individuals was analyzed using Cox proportional hazards regression models to calculate hazard ratios and 95% confidence intervals (CIs).

RESULTS: The results …

Integrating Human And Animal Health In The Stop Spillover Outbreak Scenarios, Kathleen E. Angell, He Julia Bai, Katherine C. Prager, Janetrix H. Amuguni, Felicia B. Nutter, Jonathan D. Gass Jr, David Brett-Major

Journal Articles: Epidemiology

OBJECTIVES: To generate and employ scenarios of sentinel human and animal outbreak cases in local contexts that integrate human and animal health interests and practices and facilitate outbreak risk management readiness.

METHODS: We conducted a scoping review of past outbreaks and the strengths and weaknesses of response efforts in USAID STOP Spillover program countries. This information and iterative query-and-response with country teams and local stakeholders led to curated outbreak scenarios emphasizing One Health human:animal interfaces at sub-national levels.

RESULTS: Two core scenarios were generated adapted to each of 4 countries’ pathogen priorities and workflows in Africa and Asia, anchoring on …

Schistosoma Haematobium Infection And Associated Risk Factors Among Pre-School Age Children In Gambella, Ethiopia, Tigist Mohammed, Abraham Degarege, Mulugeta Aemero, Abebe Animut, Yohannes Negash, Yirgalem Gebrehiwot, Berhanu Erko

Journal Articles: Epidemiology

Background

Method