Ph.D. - Epidemiology

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    TIMELINESS OF INFECTIOUS DISEASES CASE REPORTING IN THE WASHINGTON STATE DISEASE REPORTING SYSTEM
    ( 2023) Ingalls, Kacey Kathleen ; Hurwitz, Eric ; Epidemiology
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    LIFESTYLE ETIOLOGY OF THYROID CANCER IN A MULTIETHNIC POPULATION
    ( 2022) Abe, Janine V. ; Wilkens, Lynne ; Epidemiology
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    EXAMINING THE ROLE OF SLEEP DURATION ON THE RISK OF HYPERTENSION, STROKE, AND MORTALITY
    ( 2021) Kawai, Yosuke ; Grandinetti, Andrew ; Epidemiology
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    Examination of Healthy Growth among Children of the U.S. Affiliated Pacific Region
    ( 2020) Yamanaka, Ashley Brooke ; Novotny, Rachel ; Epidemiology
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    Comparison of Behavioral and Sexual Networking Risks among Patients with Syphilis or Gonorrhea: The Social and Sexual (SSN) Study, Baltimore
    ([Honolulu] : [University of Hawaii at Manoa], [December 2016], 2016-12) Krishnan, Vinogiri
    Syphilis is caused by the bacterium Treponema pallidum and is associated with significant complications if left untreated besides also facilitating the transmission and acquisition of ‘Human Immunodeficiency Virus’ (HIV) infection. Gonorrhea (infection due to Neisseria gonorrhoeae) is the second most commonly reported sexually transmitted disease (STD) in the United States. The purpose of this dissertation is to develop an epidemiologic profile among patients with syphiliis and gonorrhea from STD clinics in Baltimore. Networking risks and behavioral factors associated with sexual risk taking were investigated. The first of three studies sought to determine the associations between the presence of syphilis vs. gonorrhea with sexual characteristics and associations between the presence of syphilis vs. gonorrhea with peer influences on condom use before any sexual intercourse. The second study attempted to determine the associations between the network characteristics of the social contacts with the presence of syphilis vs. gonorrhea, describe differences in asscociations between sexual behaviors with presence of syphilis vs. gonorrhea by different types of networks (more sexual networks than non-sexual networks and vice versa) and determine the associations between some sexual behaviors with presence of syphilis vs. gonorrhea among men having sex with men (MSM) from this study. Finally, study three aimed to determine if depression and drug abuse are co-morbid with the presence of syphilis vs. gonorrhea among patients with syphilis or gonorrhea, describe differences in the associations of drug abuse with syphilis vs. gonorrhea between people with different types of networks and to determine if sexual abuse is associated with depression among these patients. Findings from all three studies covered in this dissertation confirm that there are behavioral factors with sexual risk and networking risks among patients with syphilis or gonorrhea. They also provided thorough information on their network characteristics and associated risk factors in different types of social networks (individuals named as part of sexual or non-sexual network). All three studies provided suggestions for future research in order to increase understanding of sexual and networking risks among patients with STDs.
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    Health among Lesbian, Gay, Bisexual and Questioning Teens in Hawai‘i: The Role of Social Support in Reducing Problematic Alcohol Use and Suicide Attempts
    ([Honolulu] : [University of Hawaii at Manoa], [December 2015], 2015-12) Lowery St John, Tonya
    Sexual minorities (SMs), gay, lesbian, bisexual and questioning individuals, experience poorer mental and physical health outcomes and increased likelihood of engaging in risky sexual behaviors, tobacco, alcohol and other illicit drug use compared to heterosexuals. The Minority Stress Model explains this excess risk by positing that unique external stressors in the SM population combine with internal stress responses to produce physiological responses and behaviors that impact the mental and physical health of SMs. These negative stressors can be mediated by personal internal and external environmental factors and mitigated by social supports. This dissertation uses data from the 2011 and 2013 Hawaii Youth Risk Behavior Survey of public high school students to explore key health issues among SM youth (SMY). The first study examined how the operationalization of the construct of sexual orientation impacts the odds of current cigarette smoking, current alcohol use and suicide attempt in the past 12 months among SMY compared to their heterosexual counterparts. There were significant differences in risk behaviors by sex, and operational definition of sexual orientation. Self-identification as SMY and sexual behavior seem to capture distinct risks. Students who are not sexually active, or who are questioning their sexual identity, should be included as a separate category in analyses rather than grouped with SMY. The second study explores alcohol use among SMY, uses the CRAFFT brief screening tool for adolescents to discern problematic alcohol use and examines the role of social supports in mediating problematic alcohol use among SMY. Social supports were important predictors of problematic use and parental disapproval of underage drinking was strongly associated with lower problematic alcohol use. The final study describes suicidal behavior among SMY and scrutinizes the role of social supports in mediating the excess risk of recent suicide attempts, controlling for measures of victimization. Victimization was strongly associated with suicide risk; adult support outside of school was protective. Together these studies may help set standards for appropriate analytical methods for SMY and contribute to the body of research on the role of interpersonal social supports in reducing the negative effects of stress on the health of SMY.