Epidemiology Commons^™

An Impact Assessment Of The Effectiveness Of Utilizing Informal Health Communication Interventions To Spread Health Recommendations And Change Public Perception, Lina Mohamed Ezzat Ahmed Abdel Mawgoud

Theses and Dissertations

Brain health is an increasingly urgent but critically under-addressed public health priority in Egypt and the wider MENA region. Despite its centrality to aging, productivity, and overall quality of life, public understanding of brain health remains limited, and stigma continues to shape responses to dementia and cognitive decline. This study evaluates the effectiveness of informal, culturally adapted health communication as a tool to shift perception, increase awareness, and promote behavior change among non-medically trained adults in Egypt.

Grounded in global evidence on cognitive reserve, neuroplasticity, and the life-course approach to brain health, the intervention translated expert-informed brain health recommendations into …

Community And Individual Risk Factors Associated With Tuberculosis Treatment Outcomes: Ca, Md, And Oh, [2017-2021]., Kadiatu Banjoko

Walden Dissertations and Doctoral Studies

There are unsuccessful treatment outcomes with Tuberculosis (TB) disease, although effective therapies exist. This study aimed to identify predictors of unsuccessful treatment using the socioecological model. A quantitative cross-sectional study and multinomial logistic regression analysis were used to measure the associations between long-term care (LTC), homelessness, correctional facility, Human Immunodeficiency Virus (HIV), diabetes, excess alcohol, illicit drug use, and TB treatment outcomes of death, lost to follow-up, and treatment refusal. The sample consisted of 7,589 individuals aged 15 and older with pulmonary TB between 2017 and 2021, residing in California, Ohio, and Maryland. Findings indicated a correlation between community factors …

Clinical, Imaging And Blood Biomarker Outcomes In A Phase 3 Clinical Trial Of Tau Aggregation Inhibitor Hydromethylthionine Mesylate In Mild Cognitive Impairment And Mild To Moderate Dementia Due To Alzheimer’S Disease, Claude Wischik, Richard G. Stefanacci, Peter Bentham, Serge Gauthier, Henrik Zetterberg, Gordon Wilcock, Lutz Froelich, Alistair Burns, Emer Macsweeney, Clive Ballard, Jin-Tai Yu, Tay Siew Choon, Vahe Asvatourian, Natalia Muehlemann, Jan Priel, Karin Kook, Tenecia Sullivan, Diane Downie, Sonya Miller, Carol Pringle, John Storey, Tom Baddeley, Charles R Harrington, Lewis Penny, Mohammad Arastoo, Roger Staff, Anca-Larisa Sandu, Helen Shiells, Serena Lo, Nafeesa Nazlee, Emily Evans, Claire Hull, Bjoern Schelter

College of Population Health Faculty Papers

BACKGROUND: Hydromethylthionine mesylate (HMTM) targets tau pathology and has tau-independent symptomatic activity.

OBJECTIVES: To evaluate the safety and efficacy of HMTM in participants with mild cognitive impairment (MCI) and mild to moderate dementia due to Alzheimer's disease (AD).

SETTING: 82 centres in Canada, European Union, United Kingdom and United States of America.

PARTICIPANTS: A total of 598 amyloid β-PET positive participants were included; 44% (263) met clinical criteria for MCI due to Alzheimer's disease and 56% (335) were diagnosed with mild to moderate dementia due to AD.

INTERVENTION: HMTM 16 mg/day and 8 mg/day were compared with methylthioninium chloride (MTC) …

Dietary Inflammatory Index And Risk Of Colorectal Cancer In Japanese Men, Ayaka Kotemori, Kumiko Kito, Motoki Iwasaki, Taiki Yamaji, James Hébert Scd, Junko Ishihara, Manami Inoue, Shoichiro Tsugane, Norie Sawada On The Behalf Of Jphc Study Group

Faculty Publications

Background/Objectives: Unhealthy lifestyles lead to chronic low-grade inflammation, increasing the risk of colorectal cancer. Few studies in East Asia have examined the association between the dietary inflammation potential and colorectal cancer incidence. Therefore, we aimed to investigate this association further in the Japanese population. Methods: This study included 38,807 men aged 45–74 years who participated in the Japan Public Health Center-based prospective study (JPHC Study). The energy-adjusted dietary inflammatory index (E-DII) was derived from a food frequency questionnaire. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. Differences in risk due to a …

Postdischarge Pediatric Mortality In Nigeria For Children Under 5 Years Of Age, Philomina Nwaugo Chukwudike

Walden Dissertations and Doctoral Studies

Child mortality has remained a public health issue that is prevalent among families living in Nigeria and low- and middle-income countries. Factors associated with post-discharge pediatric mortality among children under 5 have not been explored. The study involved examining associations between timely individual follow-up visits, availability of healthcare facilities for follow-up care, and likelihood of post-discharge mortality among children under 5 while adjusting for household income, geographical location, mothers’ age, and mothers’ education. The theoretical framework was the social ecological model. Data were generated from the 2018 Demographic and Health Survey. A sample size of N=21,671 was used to determine …

Protocol For The Development Of The Who Gestational Weight Gain Charts, Thais Rangel Bousquet Carrilho, Olufemi Taiwo Oladapo, Jennifer A. Hutcheon, Giovanna Gatica-Domínquez, Kathleen M. Rasmussen, Monica C. Flores-Urrutia, Richard Kumapley, Ӧzge Tunçalp, Dang Bahya-Batinda, Amel A. Fayed, Annick Bogaerts, Aris T. Papageorghiou, Cinthya Muñoz-Manrique, Dayana Rodrigues Farias, Eric Ohuma, Harshpal Sachdev, Hayfaa A. Wahabi, Helena J. Teede, Molin Wang, Nandita Perumal Phd

Faculty Publications

Introduction Gestational weight gain (GWG) is an important indicator of maternal nutrition to be monitored during pregnancy. However, there is no evidence-based tool that can be used to monitor it across all geographic locations and pre-pregnancy body mass index (BMI) categories. The WHO is undertaking a project to develop GWG charts by pre-pregnancy BMI category, and to identify GWG ranges associated with the lowest risks of adverse maternal and infant outcomes. This protocol describes all the steps that will be used to accomplish the development of these GWG charts.

Methods and analysis This project will involve the analysis of individual …

Sociodemographic And Hiv-Related Characteristics Associated With Mental Health Diagnoses Among People Living With Hiv, Monique J. Brown Ph.D., Mph, Jiayang Xiao, Xueying Yang Ph.D., Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Mental health diagnoses have been linked to poor HIV treatment outcomes and poorer quality of life among people living with HIV (PLWH). Therefore, this study aimed to investigate the association between sociodemographic and HIV-related characteristics, and common and serious mental health disorders among PLWH in South Carolina (SC). Data were obtained from the integrated system of statewide electronic health record (EHR) data in SC (2006–2019; N = 8,124). Multivariable logistic regression models were used to determine the associations between sociodemographic and HIV-related characteristics, and common mental health disorders and serious mental health disorders. Among the study population, 4% were 60 …

Utilizing Machine Learning Techniques For Computer-Aided Covid-19 Screening Based On Clinical Data, Honglun Xu, Andrews T. Anum, Michael Pokojovy, Sreenath Chalil Madathil, Yuxin Wen, Md. Fashiar Rahman, Tzu-Liang Bill Tseng, Scott Moen, Eric Walser

Engineering Faculty Articles and Research

The COVID-19 pandemic has highlighted the importance of rapid clinical decision-making to facilitate the efficient usage of healthcare resources. Over the past decade, machine learning (ML) has caused a tectonic shift in healthcare, empowering data-driven prediction and decision-making. Recent research demonstrates how ML was used to respond to the COVID-19 pandemic. This paper puts forth new computer-aided COVID-19 disease screening techniques using six classes of ML algorithms (including penalized logistic regression, random forest, artificial neural networks, and support vector machines) and evaluates their performance when applied to a real-world clinical dataset containing patients’ demographic information and vital indices (such as …

Factors Affecting The Level Of Grief Experienced By Men Whose Female Partner Died In The United States, Keona C. Lee

Walden Dissertations and Doctoral Studies

Grief is an emotional reaction to the loss of a loved one through death. Although grief is a universal human experience, its perspective is unique, and research has often ignored the varied experiences of racial/ethnic and cultural groups, particularly men of color in the United States. The purpose of this quantitative study was to measure the level of grief experienced by men whose female partner died and to determine whether ethnicity, having a prior mental health diagnosis, social support, and traumatic or anticipated loss significantly impacted their level of grief. The study was guided by the social-ecological model to explain …

Multiple Myeloma Risk Linked To Dna Damage Response Genes, Michael Conry, Irina Ostrovnaya, Yelena Kemel, Saloni Sinha, Linda B. Baughn, Brian Avery, Kylee Maclachlan, Victoria Groner, Lauren Banaszak, Aaron Norman, Nicholas J. Boddicker, Alyssa I. Clay-Gilmour Ph.D., Shaji Kumar, Ellen Kim, Sita Dandiker, Mitul Waghmare, Susan Slager, Douglas Sborov, Judy Garber, Elizabeth E. Brown, Michelle Hildebrandt, Et. Al.

Faculty Publications

Background DNA damage response genes (DDRG), implicated in several cancers as both predisposing risk factors as well as biomarkers for aggressiveness, have not been fully explored in multiple myeloma (MM).

Methods Herein, we analyzed disease associations of pathogenic variations in nine putative candidate genes using 3 446 MM cases and 323 233 cancer-free controls.

Results Increased MM risk was found to be associated with inherited rare pathogenic mutations in TP53, ATM, CHEK2, KDM1A, and ARID1A, with an enrichment of these variants among individuals with early onset or family history of MM. Individuals with TP53 or ATM germline mutations are also …

Optimal Intervention Strategies In Age-Structured Sirvd Model: Epidemiological And Economic Analysis Of Covid-19 In Korea, Joon Chun, Melisa Hendrata

Spora: A Journal of Biomathematics

This study employed an age-structured Susceptible-Infected-Recovered-Vaccinated-Deceased (SIRVD) model to design optimal COVID‑19 intervention strategies by integrating epidemiological dynamics with economic costs. Using empirical data from South Korea, we estimated transmission parameters and analyzed quarantine-based non-pharmaceutical interventions (NPIs) alongside targeted vaccination scenarios. Our results indicated that a stronger form of mild NPI (upper range of Level I), when combined with targeted vaccination that prioritized seniors, achieved substantial reductions in infection peaks and overall economic burden. These findings underscore the effectiveness of age-specific strategies in epidemic management and offer critical insights for policymakers seeking balanced, resource-efficient approaches.

West Nile Virus Transmission Suitability Modeling For Culex Pipiens Via Temperature And Humidity, Hunter Jones, David Brett-Major, Joseph R. Fauver, Yeongjin Gwon, Jesse E. Bell

Journal Articles: Epidemiology

West Nile Virus (WNV) is the leading cause of mosquito-borne disease in the United States, yet predicting its transmission remains a significant challenge for public health officials. Many studies use correlative statistical models to predict disease cases using temperature and humidity, but accessible mechanistic approaches that simulate mosquito behavior traits can capture more of the transmission process. This study adapts an existing R-language package, the Mosquito-borne Viral Suitability Estimator (MVSE), which was created to model Aedes aegypti mosquito transmission of dengue, and tunes it to Culex pipiens transmission of WNV. Equations for mortality, biting rate, and incubation period were updated, …

Factors Affecting Detection And Quantification Of Schistosoma Haematobium Eggs In Pooled Urine Samples, Abraham Degarege, Bruno Levecke, Christopher R. Bilder, David Brett-Major, Abebe Animut, Yohannes Negash, M. Jana Broadhurst, Tzeyu L. Michaud, Berhanu Erko

Journal Articles: Epidemiology

BACKGROUND: Building on our previous work showing that pooled urine testing can rapidly detect Schistosoma haematobium infections but has limited sensitivity in low-intensity settings or with large pool sizes, this study evaluated how urine volume, pool size, infection intensity, and diagnostic method affect the detection and quantification of S. haematobium eggs in pooled samples.

METHODS: Between July 2022 and April 2023, 2,134 urine samples from school-age children living in three regional states of Ethiopia were individually examined by deploying urine filtration microscopy (UFM). Subsequently, 5, 10, 20 and 40 individual samples were strategically pooled and examined by deploying UFM and …

Access To Appropriate Care, Mortality, And Cost Of Inpatient Hospitalization In Infants With Omphalocele And Gastroschisis In The United States, Treeva A. Jaff

Electronic Theses & Dissertations (2024 - present)

Congenital abdominal wall defects (AWDs), including omphalocele (OM) and gastroschisis (GS), are rare but clinically significant conditions that require immediate surgical intervention and prolonged neonatal intensive care. OM is a midline defect in which abdominal organs protrude into the umbilical cord covered by a membranous sac, while GS is a full-thickness defect typically located to the right of the umbilicus through which organs protrude without protective coverage. OM is frequently associated with major co-occurring congenital anomalies and chromosomal abnormalities, while GS more commonly occurs as an isolated defect but requires more intensive surgical management. As survival rates have improved, research …

Trends Among Suspected Opioid Overdose Emergency Medical Service (Ems) Incidents In Georgia From 2019-2023, Ashton Harris

College of Graduate Studies: Theses & Dissertations

Opioid overdoses remain a problem in the United States, underscoring the need for additional surveillance tools to monitor trends in opioid overdoses. Emergency Medical Services (EMS) data is a timely surveillance method that captures more potential overdoses than hospitals by representing the pre-hospital setting. Research questions in the study assess EMS responses to suspect opioid overdose incidents from 2019-2023 in Georgia to encompass the following characteristics: timeframe (pre, during, post-pandemic), urban versus rural counties, race/ethnicity, categorical type of first responder, mean dosage of naloxone in milligrams administered, and death. 84,359 records meeting the inclusion criteria were initially retrieved from the …

“Kuchoka”: Investigation Of Research Fatigue In Mosoriot, Kenya, Felishana Cherop, Violet Naanyu, Juddy Wachira, Lukoye Atwoli

Internal Medicine, East Africa

Background: Health research is key to the promotion of population and community health, however, conducting many research studies in a community can cause research fatigue.

Purpose: We determined the prevalence of research fatigue and associated factors in Mosoriot, Kenya.

Methods: We conducted a cross-sectional study in the Mosoriot community from Wednesday 28, May 2014, to Thursday 30, April 2015, involving (n = 327) community members who were randomly sampled to respond to self-administered and/or guided questionnaires. We analyzed descriptive statistics to summarise the data and used the Pearson Chi-Square test to assess the bivariate associations between the …

Association Of Valvular Disease Progression Using Echocardiographic Findings In A Large U.S. Cohort, Abes A. Bautista Neughebauer, Amin Yehya, Raymond L. Benza, Deepak Talreja

Department of Medicine Faculty Publications

Background

The prevalence of valvular disease in the US is approximately 2.5%. Given that over 5 million Americans are affected, it is crucial to find those at higher risk of progression. The goal of this paper is to uncover which patients are more likely to have valvular disease progression using demographic factors, EKG and echocardiogram (ECHO) findings.

Methods

This paper utilized the EchoNext Database, which pairs 100,000 electrocardiograms and echocardiograms based on specific structural heart disease labels. Univariate and multivariate logistic regression were used to find risk factors for progression for aortic stenosis (AS), aortic regurgitation (AR), mitral regurgitation (MR), …

Meconium Metal Concentrations And Infant Temperament And Development, Fiona Fogarty

Dissertations and Theses

BACKGROUND: Prenatal exposure to metals poses significant health consequences for early childhood development. Understanding the factors influencing metal concentrations that infants are exposed to in-utero is crucial for developing targeted interventions, particularly when maternal characteristics and environmental factors, may contribute to varying levels. Meconium offers insight into in-utero exposures for the developing infant, and the effect of each individual metal may be mediated or exacerbated by another and therefore should be studied in the context of a mixture. The effect of metal mixture exposure, as measured in meconium, on milestone and temperament outcomes has yet to be determined.

DESIGN: …

The Mediating Effect Of Socioeconomic Status And Persistent Poverty On Racial And Ethnic Disparities In Pediatric Cancer Mortality In The United States, Josiane Kabayundo, Apu Das, Cheng Zheng, Emma Hymel, Krishtee Napit, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

BACKGROUND: Socioeconomic (SE) factors have been shown to mediate racial and ethnic disparities in adult cancer mortality. However, evidence in pediatric cancer is limited, especially at finer geographic levels.

OBJECTIVE: Evaluate the mediating effect of socioeconomic status (SES) and persistent poverty in racial and ethnic disparities in childhood cancer mortality using census tract-level data.

METHODS: Data were obtained from the 2006-2020 SEER Incidence Data with Census Tract Attributes Database and included children 0-19 years. Neighborhood-level SES was measured using a composite variable with five categories. Census tracts were classified as persistently poor if 20% or more of the population lived …

Ebola In The Drc: A Different Problem Compounded By Violence, David Brett-Major

Journal Articles: Epidemiology

A Public Health Emergency of International Concern (PHEIC) has been declared in the Democratic Republic of Congo (DRC) due to Ebola disease from Bundibugyo virus. Non-health-focused factors should be fundamental to how DRC and its partners respond to and recover from the current emergency. Filovirus emergencies are violent in every sense-the disease experience of patients and their caregivers, the tumult in impacted communities, sometimes the physical manifestations of frustration against healthcare services, the fits and starts of concerted response, and the milieu of conflict in which this emergency occurred. Yet, interpersonal and organized violence may contribute to frequency of health …