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Background: Pertussis diagnosis may go unrecognized when other pathogens, such as respiratory syncytial virus (RSV) circulate. Methods: A prospective cross-sectional study was conducted in Lima, Peru from January 2009 to September 2010. A total of 596 children under 5 years old admitted with clinical diagnoses of acute respiratory infections were test for B. pertussis and RSV detection by polymerase chain reaction (PCR). Results: The pertussis toxin and IS481 genes were detected in 19.12% (114/596) of the cases and the respiratory syncytial viruses (RSV-A and RSV-B) were identified in 17.28% (103/596) of patients. Infants under 3 months old were the most frequently affected by this pathogens in 43% (49/114) and 35.9% (37/103) respectively. An increase of B. pertussis was observed from February to March and from October to November with a Seasonal index between 1.32-1.51 and 1.24-3.5 respectively. Conclusions: Epidemiologic surveillance for B. pertussis is essential in Peru, especially in children that could most benefit from the vaccine. B. pertussis should be suspected in infants hospitalized for acute respiratory symptoms for early treatment and prevent complications. / Tesis

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Counties of Appalachia have long been linked to significant health disparities, including low birth weight infants. Low birth weight is directly related to cognitive and physical developmental delays and long-term health effects such as respiratory and congenital disabilities. On average, women residing in Appalachia have lower educational achievement and incomes and face barriers to accessing essential healthcare services, often associated with poor birth outcomes. However, Appalachia is not a monolith, and there is considerable variability in underlying levels of vulnerability and resources within Appalachia. This study examines variation in low birth weight (LBW) by sub-region of Appalachia. A cross-sectional study using 2022 County Health Rankings (CHR) data and Appalachian Regional Commission (ARC) sub-region designations were used to examine the extent to which the percentage of LBW infants varies across Appalachian sub-regions. The percentage of LBW infants at the county level was the dependent variable of interest, and the Appalachian sub-regions were the independent variable of interest. Analysis of variance (ANOVA) was used to compare the mean percentage of LBW infants among Appalachian sub-regions. Means and standard deviations of the percent of infants born at LBW were examined by sub-region and across other variables of interest, including the percentage of the population that was uninsured, of non-Hispanic Black race/ethnicity, had a high school diploma or equivalent, current adult smokers, children in poverty, food insecure, and individuals residing in a rural area. Overall, 90% of the population living in the Appalachian counties have received a high school diploma or equivalent, 11% of all individuals, children, and adults are uninsured, 24% of the adult population admits to smoking daily, nearly 21% of counties have children living at or below the federal poverty baseline, 68% of the counties are classified as rural, and 15% identify as having food insecurity. Almost 7% of the population is non-Hispanic Black. The Southern sub-region had the highest mean percentage of LBW infants (9.8%), followed by Central Appalachia (9.4%), while the Northern sub-region had the lowest (7.6%). The national value for LBW infants is 8.52%. This rate is comparatively lower than all Appalachia sub-regions, except for the Northern sub-region. Our study found that the Southern sub-region of Appalachia had the highest percentage of LBW infants among the sub-regions. These results are unsurprising given the well-documented relationship between LBW infants born to non-Hispanic Black women. Southern sub-region counties of Appalachia span parts of South Carolina, Georgia, Alabama, and Mississippi, all of which have higher proportions of non-Hispanic Black women as a percentage of the overall population. Central Appalachia, however, is predominantly white. Higher rates of LBW infants among this sub-region likely reflect significant differences in access to resources and health behaviors that are more common in Central Appalachia than in other sub-regions. Furthermore, the Northern sub-region of Appalachia is significantly less rural and better resourced than the other sub-regions, which may explain lower occurrences of LBW infants. A limitation of this study includes using CHR as a primary data source, which is compiled from state and national data.

<p> This thesis is concerned with the systematic variation of stimulus movement and complexity in order to investigate developmental changes in visual fixation. It was shown that there is a developmental transition in the way in which infants extract visual information from the environment, with younger infants responding primarily through length of fixation, and older infants through the number of fixations. It was demonstrated that the faster a stimulus moves, the more fixation it elicits from infants; that older infants appear to be more responsive to differences in speed than younger infants; and that the more complex the stimulus, the greater the visual response to it. Percent measures were found to be more reliable than absolute measures in making age comparisons. </p> / Thesis / Doctor of Philosophy (PhD)

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