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This study evaluates medical pluralism among 1.5 generation Indian American immigrants. 1.5 generation Indian Americans (N=16) were surveyed regarding their engagement in complementary and alternative medical systems (CAM), how immigration affected that, and reasons for and for not continuing the use of CAM. Results indicated most 1.5 Indian immigrants currently

This study evaluates medical pluralism among 1.5 generation Indian American immigrants. 1.5 generation Indian Americans (N=16) were surveyed regarding their engagement in complementary and alternative medical systems (CAM), how immigration affected that, and reasons for and for not continuing the use of CAM. Results indicated most 1.5 Indian immigrants currently engage in CAM, given that their parents also engage in CAM. The top reasons respondents indicated continued engagement in CAM was that it has no side effects and is preventative. Reasons for not practicing CAM included feeling out of place, not living with parents or not believing in CAM. After immigration, most participants decreased or stopped their engagement in CAM. More women than men continued to practice CAM after immigration. From the results, it was concluded that CAM is still important to 1.5 generation Indian immigrants.
ContributorsMurugesh, Subhiksha (Author) / Stotts, Rhian (Thesis director) / Mubayi, Anuj (Committee member) / School of Human Evolution & Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
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Due to the COVID-19 pandemic, declared in March of 2020, there have been many lifestyle changes which have likely influenced tobacco smoking behavior. Such lifestyle changes include lockdowns, stay at home orders, reduction in social cues related to smoking, increased stress, and boredom among other things. This study utilized a

Due to the COVID-19 pandemic, declared in March of 2020, there have been many lifestyle changes which have likely influenced tobacco smoking behavior. Such lifestyle changes include lockdowns, stay at home orders, reduction in social cues related to smoking, increased stress, and boredom among other things. This study utilized a cross-sectional survey which looked into these behaviors, primarily perceived risk to COVID-19, and determined if there is an association between perceived risk and education level/race. Education level is a proxy for income and material resources, therefore making it more likely that people with lower levels of education have fewer resources and higher perceived risk to negative effects of COVID-19. Additionally, people of color are often marginalized in the medical community along with being the target of heavy advertising by tobacco companies which have likely impacted risk to COVID-19 as well.

ContributorsLodha, Pratishtha (Author) / Leischow, J. Scott (Thesis director) / Pearson, Jennifer (Committee member) / School of Life Sciences (Contributor) / School of Human Evolution & Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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Description
Understanding the consequences of changes in social networks is an important an-

thropological research goal. This dissertation looks at the role of data-driven social

networks on infectious disease transmission and evolution. The dissertation has two

projects. The first project is an examination of the effects of the superspreading

phenomenon, wherein a relatively few individuals

Understanding the consequences of changes in social networks is an important an-

thropological research goal. This dissertation looks at the role of data-driven social

networks on infectious disease transmission and evolution. The dissertation has two

projects. The first project is an examination of the effects of the superspreading

phenomenon, wherein a relatively few individuals are responsible for a dispropor-

tionate number of secondary cases, on the patterns of an infectious disease. The

second project examines the timing of the initial introduction of tuberculosis (TB) to

the human population. The results suggest that TB has a long evolutionary history

with hunter-gatherers. Both of these projects demonstrate the consequences of social

networks for infectious disease transmission and evolution.

The introductory chapter provides a review of social network-based studies in an-

thropology and epidemiology. Particular emphasis is paid to the concept and models

of superspreading and why to consider it, as this is central to the discussion in chapter

2. The introductory chapter also reviews relevant epidemic mathematical modeling

studies.

In chapter 2, social networks are connected with superspreading events, followed

by an investigation of how social networks can provide greater understanding of in-

fectious disease transmission through mathematical models. Using the example of

SARS, the research shows how heterogeneity in transmission rate impacts super-

spreading which, in turn, can change epidemiological inference on model parameters

for an epidemic.

Chapter 3 uses a different mathematical model to investigate the evolution of TB

in hunter-gatherers. The underlying question is the timing of the introduction of TB

to the human population. Chapter 3 finds that TB’s long latent period is consistent

with the evolutionary pressure which would be exerted by transmission on a hunter-

igatherer social network. Evidence of a long coevolution with humans indicates an

early introduction of TB to the human population.

Both of the projects in this dissertation are demonstrations of the impact of var-

ious characteristics and types of social networks on infectious disease transmission

dynamics. The projects together force epidemiologists to think about networks and

their context in nontraditional ways.
ContributorsNesse, Hans P (Author) / Hurtado, Ana Magdalena (Thesis advisor) / Castillo-Chavez, Carlos (Committee member) / Mubayi, Anuj (Committee member) / Arizona State University (Publisher)
Created2019
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Description
The severity of the health and economic devastation resulting from outbreaks of viruses such as Zika, Ebola, SARS-CoV-1 and, most recently, SARS-CoV-2 underscores the need for tools which aim to delineate critical disease dynamical features underlying observed patterns of infectious disease spread. The growing emphasis placed on genome sequencing to

The severity of the health and economic devastation resulting from outbreaks of viruses such as Zika, Ebola, SARS-CoV-1 and, most recently, SARS-CoV-2 underscores the need for tools which aim to delineate critical disease dynamical features underlying observed patterns of infectious disease spread. The growing emphasis placed on genome sequencing to support pathogen outbreak response highlights the need to adapt traditional epidemiological metrics to leverage this increasingly rich data stream. Further, the rapidity with which pathogen molecular sequence data is now generated, coupled with advent of sophisticated, Bayesian statistical techniques for pathogen molecular sequence analysis, creates an unprecedented opportunity to disrupt and innovate public health surveillance using 21st century tools. Bayesian phylogeography is a modeling framework which assumes discrete traits -- such as age, location of sampling, or species -- evolve according to a continuous-time Markov chain process along a phylogenetic tree topology which is inferred from molecular sequence data.

While myriad studies exist which reconstruct patterns of discrete trait evolution along an inferred phylogeny, attempts to translate the results of phyloegographic analyses into actionable metrics that can be used by public health agencies to direct the development of interventions aimed at reducing pathogen spread are conspicuously absent from the literature. In this dissertation, I focus on developing an intuitive metric, the phylogenetic risk ratio (PRR), which I use to translate the results of Bayesian phylogeographic modeling studies into a form actionable by public health agencies. I apply the PRR to two case studies: i) age-associated diffusion of influenza A/H3N2 during the 2016-17 US epidemic and ii) host associated diffusion of West Nile virus in the US. I discuss the limitations of this (and Bayesian phylogeographic) approaches when studying non-geographic traits for which limited metadata is available in public molecular sequence databases and statistically principled solutions to the missing metadata problem in the phylogenetic context. Then, I perform a simulation study to evaluate the statistical performance of the missing metadata solution. Finally, I provide a solution for researchers whom are interested in using the PRR and phylogenetic UTMs in their own genomic epidemiological studies yet are deterred by the idiosyncratic, error-prone processes required to implement these methods using popular Bayesian phylogenetic inference software packages. My solution, Build-A-BEAST, is a publicly available, object-oriented system written in python which aims to reduce the complexity and idiosyncrasy of creating XML files necessary to perform the aforementioned analyses. This dissertation extends the conceptual framework of Bayesian phylogeographic methods, develops a method to translates the output of phylogenetic models into an actionable form, evaluates the use of priors for missing metadata, and, finally, provides a solution which eases the implementation of these methods. In doing so, I lay the foundation for future work in disseminating and implementing Bayesian phylogeographic methods for routine public health surveillance.
ContributorsVaiente, Matteo (Author) / Scotch, Matthew (Thesis advisor) / Mubayi, Anuj (Committee member) / Liu, Li (Committee member) / Arizona State University (Publisher)
Created2020
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Description
Neglected tropical diseases (NTDs) comprise of diverse communicable diseases that affect mostly the developing economies of the world, the “neglected” populations. The NTDs Visceral Leishmaniasis (VL) and Soil-transmitted Helminthiasis (STH) are among the top contributors of global mortality and/or morbidity. They affect resource-limited regions (poor health-care literacy, infrastructure, etc.) and

Neglected tropical diseases (NTDs) comprise of diverse communicable diseases that affect mostly the developing economies of the world, the “neglected” populations. The NTDs Visceral Leishmaniasis (VL) and Soil-transmitted Helminthiasis (STH) are among the top contributors of global mortality and/or morbidity. They affect resource-limited regions (poor health-care literacy, infrastructure, etc.) and patients’ treatment behavior is irregular due to the social constraints. Through two case studies, VL in India and STH in Ghana, this work aims to: (i) identify the additional and potential hidden high-risk population and its behaviors critical for improving interventions and surveillance; (ii) develop models with those behaviors to study the role of improved control programs on diseases’ dynamics; (iii) optimize resources for treatment-related interventions.

Treatment non-adherence is a less focused (so far) but crucial factor for the hindrance in WHO’s past VL elimination goals. Moreover, treatment non-adherers, hidden from surveillance, lead to high case-underreporting. Dynamical models are developed capturing the role of treatment-related human behaviors (patients’ infectivity, treatment access and non-adherence) on VL dynamics. The results suggest that the average duration of treatment adherence must be increased from currently 10 days to 17 days for a 28-day Miltefosine treatment to eliminate VL.

For STH, children are considered as a high-risk group due to their hygiene behaviors leading to higher exposure to contamination. Hence, Ghana, a resource-limited country, currently implements a school-based Mass Drug Administration (sMDA) program only among children. School staff (adults), equally exposed to this high environmental contamination of STH, are largely ignored under the current MDA program. Cost-effective MDA policies were modeled and compared using alternative definitions of “high-risk population”. This work optimized and evaluated how MDA along with the treatment for high-risk adults makes a significant improvement in STH control under the same budget. The criticality of risk-structured modeling depends on the infectivity coefficient being substantially different for the two adult risk groups.

This dissertation pioneers in highlighting the cruciality of treatment-related risk groups for NTD-control. It provides novel approaches to quantify relevant metrics and impact of population factors. Compliance with the principles and strategies from this study would require a change in political thinking in the neglected regions in order to achieve persistent NTD-control.
ContributorsThakur, Mugdha (Author) / Mubayi, Anuj (Thesis advisor) / Hurtado, Ana M (Committee member) / Paaijmans, Krijn (Committee member) / Michael, Edwin (Committee member) / Arizona State University (Publisher)
Created2020
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Description
Ecological modeling can be used to analyze health risk behaviors and their relationship to ecological factors, which is useful in determining how social environmental factors influence an individual’s decisions. Environmental interactions shape the way that humans behave throughout the day, either through observation, action, or consequences. Specifically, health risk behaviors

Ecological modeling can be used to analyze health risk behaviors and their relationship to ecological factors, which is useful in determining how social environmental factors influence an individual’s decisions. Environmental interactions shape the way that humans behave throughout the day, either through observation, action, or consequences. Specifically, health risk behaviors can be analyzed in relation to ecological factors. Alcohol drinking among college students has been a long concern and there are many risks associated with these behaviors in this population. Consistent engagement in health risk behaviors as a college student, such as drinking and smoking, can pose a much larger issues later in life and can lead to many different health problems. A research study was conducted in the form of a 27 question survey to determine and evaluate the impact of ecological factors on drinking and smoking behaviors among Arizona State University students. Ecological factors such as demographics, living conditions, contexts of social interactions, and places where students spend most of their time were used to evaluate the relationship between drinking and smoking behaviors and the ecological factors, both on- and off- campus.
ContributorsAndrade, Amber Marie (Co-author) / Naik, Sparshee (Co-author) / Werbick, Meghan (Co-author) / Mubayi, Anuj (Thesis director) / Gaughan, Monica (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05