Epidemiology Commons^™

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Micro/Nanoplastics And Cancer: Focus On Gastrointestinal Malignancies - A Narrative Review, Sana Rabeeah, Priyata Dutta, Ahmad Mahdi, Alejandra Vargas, Edward C. Oldfield, David A. Johnson

Department of Medicine Faculty Publications

Micro- and nanoplastics (MNPs) are plastic particles smaller than 5 mm and 1 μm, respectively, and are emerging environmental pollutants with growing implications for human health. These particles stem from either 'primary sources', such as intentionally manufactured microbeads and industrial abrasives, or 'secondary sources', where larger plastic items break down into smaller fragments over time. Human exposure primarily occurs through ingestion and inhalation, with contaminated seafood and plastic-laden food packaging representing key routes of entry. Once ingested, MNPs can cross the intestinal barrier, accumulate in gastrointestinal (GI) tissues, and trigger biological responses. Mechanistic studies reveal that MNPs induce oxidative stress, …

Multisociety Guidance For Infection Prevention And Control In Nursing Homes, Lona Mody, Sonali D. Advani, Muhammad Salman Ashraf, Allison H. Bartlett, Suzanne F. Bradley, Deborah P. Burdsall, Jennifer A. Hanrahan, Susan S. Huang, Robert L.P. Jump, Lindsay Nicolle, Mary-Claire Roghmann, Patricia Stone, Rekha K. Murthy

Department of Medicine Faculty Publications

This multisociety guidance was endorsed by SHEA, APIC, IDSA, PALTmed, and AGS. It provides recommendations for infection prevention and control (IPC) in the context of the complexity of nursing home care in the United States: increased medical acuity of residents, the spread of multidrug-resistant organisms, and the threat of emerging pathogens. Recommendations and implementation suggestions address IPC leadership, staffing, and resources, healthcare personnel and residents‘ adherence to precautions and effective hand hygiene, outbreak preparedness, training, occupational health, cleaning and disinfection in the care environment, and the involvement of IPC in the facility. The guidance also addresses the challenges of maintaining …

Faktor Risiko Kejadian Hipertensi Dalam Kehamilan Pada Ibu Hamil Di Provinsi Jawa Timur (Analisis Data Riset Kesehatan Dasar Tahun 2018), Putri Amalia Firjatillah, Sudarto Ronoatmodjo

Jurnal Epidemiologi Kesehatan Indonesia

Hypertension during pregnancy is one of the most common pregnancy complications and the leading cause of maternal mortality in Indonesia. One of the regions in Indonesia with a high number of hypertension-related pregnancy complications is East-Java Province with a prevalence rate of 17,8%. This study aims to analyze the risk factors associated with hypertension during pregnancy among pregnant women in East Java. The study adopts a cross-sectional design using secondary data from 758 pregnant women aged 15-54 years in East Java Province who participated in 2018 Riskesdas Survey during which blood pressure measurements were taken. The dependent variable analyzed in …

Determinan Faktor Dengan Ketidakpatuhan Dalam Mengonsumsi Obat Antiretroviral Pada Orang Dengan Hiv(Odhiv) Di Rumah Sakit Umum Daerah Kabupaten Tangerang Tahun 2023, Dessi Marantika Nilam Sari, Mondastri Korib Sudaryo, Syahrizal Syarif, Helwiah Umniyati, Suyono .

Jurnal Epidemiologi Kesehatan Indonesia

Ketidakpatuhan alasan utama Pasien HIV tidak menerima pengobatan ARV sehingga harus selalu dipantau dan dinilai secara teratur serta didorong pada setiap kunjungan. Penelitian ini bertujuan untuk mengamati determinan faktor terjadinya ketidakpatuhan dalam mengonsumsi obat ARV pada ODHIV yang mendapatkan terapi ARV di Rumah Sakit Umum Daerah Kabupaten Tangerang. Jenis penelitian ini menggunakan penelitian observasional dengan rancangan cross sectional. Penelitian dilakukan di poli HIV RSUD Kabupaten pada bulan November 2023 menggunakan data laporan HIV pada SIHA. Populasi penelitian berjumlah 1.337 ODHIV aktif menjalani pengobatan antiretroviral di RSUD Kabupaten Tangerang dengan menggunakan total sampling sesuai dengan kriteria inklusi dan ekslusi sehingga sampel …

Evaluation Of A 20-Item Version Of The Trauma-Related Drinking To Cope Questionnaire, Sage E. Hawn, Lauren Smith, Kaytlin Armitage, Selah Ball, Cathy Lau-Barraco, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Objectives: This study sought to develop and psychometrically evaluate an expanded version of the Trauma-Related Drinking to Cope (TRD) scale, a four-item self-report tool, which was developed to address a crucial gap in self-medication research. Before the development of the TRD, no measures existed which assessed alcohol use for coping with symptoms of posttraumatic stress disorder (PTSD) specifically. Previous work showed that the TRD has strong psychometric properties and clinical utility in its ability to identify individuals with PTSD who may be at risk for developing comorbid alcohol use disorder (AUD). The aim of the present study was to develop …

In Danger: Hiv Vaccine Research And Development In Europe, Roger Tatoud, Yves Lévy, Roger Le Grand, Jose Alcami, Giorgio Barbareschi, Christian Brander, Andrea Cara, Behazine Combadière, François Dabis, Sarah Fidler, Tomáš Hanke, Carolina Herrera, Gunilla B. Karlsson Hedestam, Hester Kuipers, Sheena Mccormack, Christiane Moog, Giuseppe Pantaleo, Laura Richert, Rogier W. Sanders, Robin Shattock, Hendrik Streeck, Rodolphe Thiebaut, Alexandra Trkola, Klaus Üeberla, Marit J. Van Gills, Ralf Wagner, Winfried Weissenhorn, Yazdan Yazdanpanah, Gabriella Scarlatti, Jean Daniel Lelièvre

Department of Obstetrics & Gynecology Faculty Publications

Highly effective antiretroviral-based HIV prevention plays an important role in ending the global HIV/AIDS epidemic. However, the sustainable control of the epidemic is hampered by unequal access to prevention options, including HIV testing, alongside with drug resistance and ongoing barriers to accessing sustainable HIV treatment. Therefore, an HIV vaccine, combined with effective prevention and treatment, remains an absolute necessity to control the epidemic. Yet, the recent discontinuation of four major vaccine efficacy studies is raising concerns about the future of HIV vaccine research and development globally, and particularly in the European region where funding for vaccine research and development has …

Dance-Related Fractures Occur In The Upper And Lower Extremities At Similar Rates: An Analysis Of The 2004-2023 National Electronic Injury Surveillance System Database, Senah E. Stephens, Joshua F. Edwards, Lisa K. Cannada

Department of Medicine Faculty Publications

Introduction

In the United States, 21% of adolescents participate in dance. Dancers are susceptible to injuries, particularly of the lower extremity, due to extreme positioning, dynamic overload, and repetitive movements.

Objectives

(1) to report the prevalence and describe demographic characteristics of dance-related fractures and (2) to analyze variables associated with disposition status.

Methods

The National Electronic Injury Surveillance System (NEISS) database, published by the US Consumer Product Safety Commission, was used to investigate dance-related fractures diagnosed in a sample of 100 emergency departments over 20 years. Descriptive statistics and demographic variables were analyzed using chi square tests. Age was analyzed …

Delayed Hypertension Diagnosis And Its Association With Cardiovascular Treatment And Outcomes, Yuan Lu, John E. Brush Jr, Chungsoo Kim, Yuntian Liu, Xin Xin, Chenxi Huang, Mitsuaki Sawano, Patrick Young, Jacob Mcpadden, Mark Anderson, John S. Burrows, Jordan R. Asher, Harlan M. Krumholz

Department of Medicine Faculty Publications

Importance Hypertension is a major risk factor for cardiovascular disease, yet delays in diagnosis may limit timely treatment initiation and increase cardiovascular risk.

Objectives To examine the timing of clinical hypertension diagnosis, its association with antihypertensive medication prescribing, and its association with long-term cardiovascular outcomes.

Design, Setting, and Participants This retrospective cohort study analyzed electronic health record (EHR) data from an integrated health care system. Adults aged 18 to 85 years with at least 2 outpatient blood pressure (BP) readings of 140/90 mm Hg or more recorded at least 30 days apart from January 1, 2010, to December 31, 2021, …

Frailty And Sleep In Adult Survivors Of Childhood Cancer: A Childhood Cancer Survivor Study Report, Lauren C. Daniel, Margaret M. Lubas, Huiqi Wang, Mariana Szklo-Coxe, Kirsten K. Ness, Annalynn M. Williams, Daniel A. Mulrooney, Rebecca Howell, Wendy Leisenring, Yutaka Yasui, Leslie L. Robinson, Gregory T. Armstrong, Eric J. Chow, Kevin R. Krull, Tara M. Brinkman

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Young adult survivors of childhood cancer exhibit rates of frailty similar to adults several decades older without a cancer history. Frailty has been associated with sleep disturbances in non-cancer populations, but the relationship has not been examined in childhood cancer survivors who are known to exhibit elevated rates of sleep problems.

Aims

Examine associations between frailty and poor sleep quality in long-term survivors of childhood cancer.

Methods

This study utilized data from 9044 participants (> 5 years from diagnosis, M(age) = 40.8 years [SD = 9.5]) in the Childhood Cancer Survivor Study. Survivors' frailty status, chronic health conditions (CHC), …

Pediatric Cancer Incidence, Temporal Trends, And Mortality In The United States By Health Disparities Indicators, Seer (1973-2014), Prachi P. Chavan, Laurens Holmes Jr.

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: Pediatric cancer incidence has been increasing in the United States, despite improvement in pediatric cancer survival. This steady increase in incidence trends is not completely understood but maybe associated with social and environmental factors. In this study we aimed to assess the cumulative incidence, temporal trends, and mortality rates in pediatric cancer. Additionally, we examined sub-group variability in both incidence and mortality rates. Methods: Data from Surveillance, Epidemiology, and End Results (SEER) −18 from 1973–2014 were used for the purpose of analysis in this study. Age-adjusted incidence rates were used to assess temporal trends in cancer among children aged < 1–19 years. Univariable and multivariable binomial regression models were used to examine the association between race and cancer mortality while adjusting for potential confounders. Results: There were 92,594 cancer diagnoses during this period. White children comprised 74,758, (80.7%), black children 10,030, (10.8%), and other races 6648, (7.2%). Overall the age-adjusted cumulative incidence was slightly higher among white children (16.4%) than black children (12.4%) and other (13.0%). Children aged 15–19 years and those in metropolitan regions were more likely to be diagnosed with pediatric cancer. Relative to females, males were 16% more likely to die from the disease [adjusted Risk Ratio (aRR): 1.16, 95% Confidence Interval (CI): 1.09–1.22]. Additionally, compared to white children, black children had higher mortality rates [(aRR): 1.37, 99% CI: 1.23–1.52]. Conclusions: There is an increasing trend in pediatric cancer incidence; while white children have the highest incidence, black children and males indicated a survival disadvantage, indicative of racial and sex variability in overall pediatric cancer in the United States.

Analyzing The Centers For Disease Control And Prevention Mortality Data Using Weekly Exceedance In Mortality Count And Weekly Change In Mortality Indicator: A Time Series Study, Aditya Chakraborty, Mohan D. Pant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background and Aims

Cause-specific mortality (CSM) count prediction plays a vital role in the context of public health policy. In this study, we introduce a new analytical approach, which is divided into three phases to answer specific questions regarding CSM due to 14 specific causes by computing different simple, compound, and conditional probabilities.

Methods

A multivariate time series forecasting model was developed using the CDC weekly mortality count data. A binary data matrix was constructed for 14 causes of death (COD) as a function of weeks by combining the observed and forecasted mortalities. We introduced two new concepts: Weekly Exceedance …

Modeling Vaccination Strategies And Intervention Impacts On Infectious Disease Dynamics, Elizabeth B. Amona

Theses and Dissertations

This dissertation explores how mathematical and statistical modeling can inform vaccination strategies and evaluate the impact of interventions during infectious disease outbreaks. Motivated by the challenges observed during the COVID-19 pandemic, the research integrates compartmental modeling, Bayesian inference, and agent-based simulation to assess policy effectiveness and disease control across varying contexts. The first study develops a SEIRDV model that incorporates government interventions and vaccination rollout to examine COVID-19 dynamics in Qatar. A Bayesian approach is used to estimate parameters and compute time-varying transmission rates. The model captures shifts in transmission following policy changes and quantifies the reduction in deaths attributable …

General Kernel Machine Methods For Multi-Omics Integration And Genome-Wide Association Testing With Related Individuals, Amarise Little, Ni Zhao, Anna Mikhaylova, Angela Zhang, Wodan Ling, Florian Thibord, Andrew D. Johnson, Laura M. Raffield, Joanne E. Curran, John Blangero

School of Medicine Publications

Integrating multi-omics data may help researchers understand the genetic underpinnings of complex traits and diseases. However, the best ways to integrate multi-omics data and use them to address pressing scientific questions remain a challenge. One important and topical problem is how to assess the aggregate effect of multiple genomic data types (e.g. genotypes and gene expression levels) on a phenotype, particularly while accommodating routine issues, such as having related subjects' data in analyses. In this paper, we extend an existing composite kernel machine regression model to integrate two multi-omics data types, while accommodating for general correlation structures amongst outcomes. Due …

Place, Culture, And Care: A Socioecological Examination Of Type 2 Diabetes Among Hispanics In The U.S., Danielle Montoya

Theses and Dissertations

Introduction: Type 2 diabetes (T2D) disproportionately affects U.S. Hispanic populations. This dissertation examined whether structural determinants fundamentally drive T2D disparities among Hispanics, with attention to within-group racial heterogeneity.

Methods: Three studies utilized nationally representative data. Study 1 examined neighborhood segregation and ethnic enclave residence associations with T2D using restricted NHANES data (2011-2018, n=5,056). Study 2 investigated acculturation and T2D associations using restricted NHANES data (2011-2018, n=4,540). Study 3 analyzed patient-provider racial/ethnic concordance and adequate diabetes care using MEPS data (2008-2021, n=17,138).

Results: Structural factors demonstrated primacy across all studies. Neighborhood segregation (aOR=1.17, p>0.05) and ethnic enclave residence showed no …

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 …

Differences In Mental Health Care Use Between Urban And Rural Populations In New York State, 2017-2022, Anna J. Papa

Electronic Theses & Dissertations (2024 - present)

Objective

This study aimed to determine whether rural New York State residents receive mental health care at the same rate as urban residents, how poverty rates in New York State relate to rurality and mental health care use, and how pre-pandemic mental health care use rates compare to 2022 use rates. The goal was not to estimate the burden of disease, nor to estimate the number of patients engaged in care in each zip code, but to highlight the potential differences in service use between urban and rural New York State Office of Mental Health clients.

Methods

A secondary analysis …

Molecular Epidemiologic Studies Of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (Me/Cfs), Anil Kumar

Electronic Theses & Dissertations (2024 - present)

Background: Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) is a disabling multisystem complex disorder with no known etiology or approved treatment. Our studies aimed to assess the link between ME/CFS and autoimmune disease (AID) and cancer, and to identify potential biomarkers and biological mechanisms to further explore pathophysiology of this diseases.

Methods: All analyses were done using data from a case-control study of ME/CFS conducted by Dr. Roxana Moslehi and her collaborators. In our first study we estimated the cumulative incidences of AID and cancer among first degree relatives of 60 cases and 61 controls and compared cumulative …

Differences In Mental Health Outcomes In Immigrant Vs. U.S.-Born Populations In Urban Vs. Rural Areas In The United States, Zoë Gentles

Electronic Theses & Dissertations (2024 - present)

Background

The immigration process to the United States creates distinct mental stressors. These stressors are influenced by socioeconomic factors including income, education level and insurance status. In rural America, these factors are intensified due to a poor healthcare infrastructure that is limited. This study examines the relationship between urban-rural residence and mental health outcomes among immigrants vs. native-born residents in the United States.

Methods

Data from the National Health Interview Survey (NHIS) from 2019 and 2022 were used to examine the relationship. The exposure of interest was place of birth, and the outcome of interest was the presence of clinically …

Polygenic Risk Scores Of Grip Strength In Men And Women With Or At Risk For Hiv, Sreevidya Sadananda Sadasiva Rao

Electronic Theses & Dissertations (2024 - present)

Background: Adequate hand function among older adults is necessary for the successful completion of activities of daily living and can affect whether an older adult is able to live independently. Current research highlights grip strength, the strength people have in their hands, as a robust predictor of morbidity and mortality, and explores the decline in grip strength over time. A person’s family history and genes (DNA) affect how much grip strength they have. Previous studies have identified genes that affect grip strength, mainly in European ancestry populations. In this study, we examined whether these genetic elements predict grip strength in …