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Articles 1 - 26 of 26
Full-Text Articles in Medicine and Health Sciences
Count Models With Multiple Inflations, Arvind Tripathi
Count Models With Multiple Inflations, Arvind Tripathi
All ETDs from UAB
The goal of this research is to develop new statistical models for the analysis of count data even if data exhibit over dispersion or under dispersion and has multiple inflated counts. Although many statistical models are available for the analysis of count data, there is no available statistical model that can address the presence of more than expected multiple counts together with over/under dispersion. In our first paper, we develop a multiple-inflation negative binomial (MINB) model and use the expectation maximization (EM) algorithm along with a numerical optimization to obtain maximum likelihood estimates. We applied the one step smoothly clipped …
Practical Extensions Of The Continual Reassessment Method, Amber Salter
Practical Extensions Of The Continual Reassessment Method, Amber Salter
All ETDs from UAB
This dissertation considers the presence of patient heterogeneity in dose finding studies using the likelihood-based time to event continual reassessment method (TITE-CRM). First, assuming group membership is known and the groups share some information regarding their maximum tolerated dose (MTD), we extend the two-group two-parameter CRM to the TITE-CRM. We examine the performance of the two-group two-parameter TITE-CRM for various scenarios where the true MTD for each group is different. We also consider the situation where the groups are truly homogeneous but a heterogeneous model is employed. Our simulations show that the method has some loss in accuracy compared to …
An Analysis Of Selecting Personal Protective Equipment Clothing Used In Foundries, Quachel Bazile
An Analysis Of Selecting Personal Protective Equipment Clothing Used In Foundries, Quachel Bazile
All ETDs from UAB
A foundry is a type of factory that deals with producing metal casting. The metals are casted in to shape by being melted into liquid and is then poured into the mold. Personal protective equipment (PPE) is worn to protect the worker from the hazard that engineering control cannot protect the worker from. A Private company wanted to evaluate their current PPE clothing to understand how well they protect a worker against molten metal splash PPE clothing was tested using the American Standard for Testing Material (ASTM) standard F955-07 entitled "Evaluating Heat Transfer through Materials for Protective Clothing upon Contact …
Obesity And Mortality In Us-Residing Hispanic Adults, Carrie Howell
Obesity And Mortality In Us-Residing Hispanic Adults, Carrie Howell
All ETDs from UAB
Previous epidemiological studies observed the lack of an association between increased body mass index (BMI: kg/m2) and all-cause mortality in US-residing Hispanic adults. The purpose of this dissertation was to examine the validity of three hypothesized explanations for the absence of significant associations. Using data on Hispanic participants from the National Health and Nutrition Examination Survey (NHANES) [1988-1994 and 1999-2004] and the National Health Interview Survey (NHIS), this dissertation examined whether: (1) BMI was associated with cause-specific mortality; (2) measures of body composition was associated with all-cause mortality; and (3) the BMI-all-cause mortality association differed as a function of Hispanic …
Three Studies On Cardiovascular Health: Modifiable Risk Factors And Health Expenditures In Medicare, Kristal Jo Aaron
Three Studies On Cardiovascular Health: Modifiable Risk Factors And Health Expenditures In Medicare, Kristal Jo Aaron
All ETDs from UAB
This dissertation comprises a series of studies conducted on modifiable risk factors as they contribute to cardiovascular health and disease and their associated health service expenditures and utilization. Specific topics in this compilation include (1) exploring the role of dietary sodium and potassium intake in cardiovascular health and disease; (2) examination of direct health expenditures in the Medicare-linked REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort as associated with Life’s Simple 7 (LS7), a composite measure of cardiovascular health defined by the American Heart Association (AHA) that is based on seven modifiable risk factors (blood pressure, blood cholesterol, …
The Investigation Of Quality Of Life, Perceived Disease Severity, And Adherence In Patients With The G551d Mutation Receiving Ivacaftor Therapy, Heather Young Hathorne
The Investigation Of Quality Of Life, Perceived Disease Severity, And Adherence In Patients With The G551d Mutation Receiving Ivacaftor Therapy, Heather Young Hathorne
All ETDs from UAB
Cystic fibrosis (CF), a genetic disorder, is a chronic life threatening illness that affects 30,000 adults and children in the United States and 70,000 worldwide. Treatment for CF is complex and consuming, consisting of multiple time intensive regimens. The therapy regimen has been descried as extraordinary when compared even to therapy regimens for other chronic illnesses. Oral and nebulized medication therapy, airway clearance therapy, pancreatic enzyme replacement therapy and vitamin /nutritional supplements are all required for the multiorgan treatment regimen for CF. Daily prescribed therapy can include as many as 40-50 pills, breathing treatments lasting up to tow hours a …
Characteristics And Behaviors Based On Introduction To Opioids Among Adults In Buprenorphine/Naloxone Treatment, Angela R. Gallien
Characteristics And Behaviors Based On Introduction To Opioids Among Adults In Buprenorphine/Naloxone Treatment, Angela R. Gallien
All ETDs from UAB
Buprenorphine/naloxone (BNT) is a pharmacological treatment for opioid use disorders and is available by prescription in an office-based setting from physicians with specialized training. The purpose of this study was to identify the characteristics and behaviors among adults on BNT with the intent to identify the linear combination of variables that account for the differences based on the origins of opioid use. Four opioid user groups were identified a priori: recreational users (RU); self-treaters (ST); medical users misusing (MUM); and medical users not misusing (MU). The dependent variables were mental health and mood, pain and medical problems, internal or external …
Individual, Family, And Social Factors Associated With Adolescent Obesity: A Policy Relevant Focus, Janice Marguerite Utley
Individual, Family, And Social Factors Associated With Adolescent Obesity: A Policy Relevant Focus, Janice Marguerite Utley
All ETDs from UAB
INDIVIDUAL, FAMILY, AND SOCIAL FACTORS ASSOCIATED WITH ADOLESCENT OBESITY: A POLICY RELEVANT FOCUS JANICE M. UTLEY PUBLIC HEALTH ABSTRACT This dissertation is comprised of three papers that examined individual, family, and social factors associated with adolescent overweight and obesity with the aim of generating data that could inform the design of policy interventions to prevent or reverse rising prevalence. The first investigation was a type of literature review called a scoping study that examined the extent, range, and type of research activity on adolescent obesity that used a multilevel or hierarchical design to look at two or more contextual areas …
Cost Effectiveness Of Hypertension Treatment: New Model, Methods, And Focus On African Americans, Gabriel Saidimu Tajeu
Cost Effectiveness Of Hypertension Treatment: New Model, Methods, And Focus On African Americans, Gabriel Saidimu Tajeu
All ETDs from UAB
This dissertation focuses on the potential benefits of hypertension (HTN) treatment for the general population and African Americans (AAs) specifically. We undertake three research projects that are interconnected. First, using a systematic review methodology we assess the current state of the cost-effectiveness of HTN treatment literature in order to identify potential gaps in the cost-effectiveness literature, methodological shortcomings, and provide policy makers and researchers with a summary of the current findings as well as methods used in the literature. Second, building off our findings in paper 1, we construct a cost-effectiveness model. We assess the cost-effectiveness of HTN treatment not …
Trends, Market Correlates, And The Impact Of Health Information Exchange, Saurabh Rahurkar
Trends, Market Correlates, And The Impact Of Health Information Exchange, Saurabh Rahurkar
All ETDs from UAB
The purpose of this dissertation is to examine the effects of Health Information Exchange (HIE) as well to evaluate hospital and market characteristics related to trends in HIE adoption. Widespread HIE is believed to boost efficiency, reduce health care costs, and improve outcomes; as such numerous efforts have aimed to promote and facilitate HIE by providers. Despite this, over a quarter of all hospitals in the U.S. do not participate in HIE and thus it is essential to examine the evidence for the theorized benefits from HIE. As such, the first paper systematically reviews the literature examining the relationship of …
Assessing Potential Diesel Exhaust Exposure In Truckers Resting At Truck Stops, Gumindenga Farayi Mabvuta
Assessing Potential Diesel Exhaust Exposure In Truckers Resting At Truck Stops, Gumindenga Farayi Mabvuta
All ETDs from UAB
The nature of long haul truck driving places workers in this occupation in a peculiar setting for chronic exposure to diesel exhaust which is a known carcinogenic. These drivers endure exposure to diesel exhaust in traffic and potentially greater exposure at truck stops where they park for rest breaks as mandated by DOT regulations. This study looked at the potential exposure to diesel exhaust in long haul truck drivers resting at truck stops where up to two hundred trucks are left idling for air conditioning and other reasons. Two different trucks were used consecutively over the 21 days of sampling. …
Presence And Mobilization Of Staphylococcus Aureus Pathogenicity Islands (Sapis) Among Bovine Mastitis Isolates, Laura Kate Parker
Presence And Mobilization Of Staphylococcus Aureus Pathogenicity Islands (Sapis) Among Bovine Mastitis Isolates, Laura Kate Parker
All ETDs from UAB
Bovine mastitis is inflammation of the mammary gland that occurs in cattle, as a result of invading bacteria. Staphylococcus aureus, a causative agent of bovine mastitis, produces toxins such as the toxic shock syndrome toxin (TSST-1) and the staphylococcal enterotoxins (SEs). The genes for these toxins are coded on S. aureus pathogenicity islands (SaPIs), which are mobile genetic elements associated with virulence factors. SaPIs can be mobilized by bacteriophages, resulting in the production of transducing particles that can spread virulence factors throughout a bacterial population. This research assessed the role and prevalence of SaPIs among bovine mastitis samples. In this …
Association Between Physical Activity And Learning, Pain Coping Strategies, Perceived Stress, And Depression Among Adults With Diabetes And Chronic Pain, Susan J. Andreae
Association Between Physical Activity And Learning, Pain Coping Strategies, Perceived Stress, And Depression Among Adults With Diabetes And Chronic Pain, Susan J. Andreae
All ETDs from UAB
In addition to the role of physical activity (PA) in the prevention of chronic disease and premature death, PA may have psychosocial benefits. We examined the association between four different domains of PA and three outcomes that may contribute to the emotional and mental well being of individuals. This is a secondary analysis of community dwelling adults with diabetes and chronic pain in which we examined the association between four domains of PA and learning (measured using diabetes knowledge, self efficacy in diabetes and pain management), pain coping strategies, perceived stress, and depression. Regression models were used to model changes …
An Examination Of Farm-To-Consumer Retail Outlet Usage Among Participants Of The Special Supplemental Nutrition Program For Women, Infants, And Children (Wic) In Birmingham, Al, Chelsea Renee Singleton
An Examination Of Farm-To-Consumer Retail Outlet Usage Among Participants Of The Special Supplemental Nutrition Program For Women, Infants, And Children (Wic) In Birmingham, Al, Chelsea Renee Singleton
All ETDs from UAB
Disparities in the neighborhood retail food environment have been hypothesized to be associated with poor diet quality and adverse health outcomes such as obesity. Studies have found that lower income communities often have reduced access to affordable healthy foods. In 2009, the Centers for Disease Control and Prevention proposed direct farm-to-consumer (FTC) retail outlets (i.e. farmers markets, farm/roadside stands, community gardens and community supported agriculture programs) as a potential strategy to alleviate retail food environment disparities in communities with limited resources. Information on the behavioral and health implications of FTC outlet usage by lower income individuals is limited. This research …
The Influence Of Personal, Interpersonal, And Community Factors On The Parenting Self-Efficacy Of First-Time Mothers, Tamika L. Smith
The Influence Of Personal, Interpersonal, And Community Factors On The Parenting Self-Efficacy Of First-Time Mothers, Tamika L. Smith
All ETDs from UAB
The Social Ecological Model (SEM) allows for examining human behavior and the factors that influence behavior change in totality. In addition, the model offers guidance in identifying the factors that may lead to a change in or explanation of behavior. This study utilizes SEM to identify factors at the personal, interpersonal, and community level in order to determine the relationship between specific ecological factors and parenting self-efficacy. Furthermore, the study examines the predictive quality of the ecological factors on parenting self-efficacy. Data collected from the Parenting for the First-time Project (PFT) was used. PFT is a multi-site longitudinal study of …
Evaluation Of Sample Size Re-Estimation Procedures For Non-Inferiority Designs With Time-To-Event Outcomes, Hwasoon Kim
Evaluation Of Sample Size Re-Estimation Procedures For Non-Inferiority Designs With Time-To-Event Outcomes, Hwasoon Kim
All ETDs from UAB
Study designs that allow sample size review may potentially save a study by identifying misspecified assumptions, modifying the planned sample size, and reinforcing the study’s power. Most sample size re-estimation (SSR) methods in non-inferiority trials have been developed for continuous or binary outcomes. In many medical domains studying cancer, heart failure, and other chronic diseases, most phase III trials use censored endpoints (e.g. survival or event-free survival). Non-inferiority designs have inherent complexity by the introduction of the non-inferiority margin and therefore understanding of strategies in these methods is essential. In our first paper, we detail the issues related to misspecification …
Spatial Analysis Of Hypertension Prevalence Using A Large Us Cohort, Matthew Loop
Spatial Analysis Of Hypertension Prevalence Using A Large Us Cohort, Matthew Loop
All ETDs from UAB
Stroke mortality rates are highest in the Southeast US, and the cause for this "Stroke Belt" is not well understood. We investigate the spatial distribution of hypertension, an important risk factor for stroke. This investigation explores statistical issues in performing spatial analysis in a large cohort (over 30,000 participants), relating to type 1 error rate control and geocoding error. Recommendations for handling these statistical issues are made. In an applied analysis, we find that hypertension prevalence varies across the continental US, and is highest in northeast Louisiana, southeast Arkansas, west Mississippi, and east Michigan. These areas are not concordant with …
Some Contributions To Bayesian Regularization Methods With Applications To Genetics And Clinical Trials, Himel Mallick
Some Contributions To Bayesian Regularization Methods With Applications To Genetics And Clinical Trials, Himel Mallick
All ETDs from UAB
Variable selection refers to the class of problems where one tries to find an optimal subset of relevant variables, which can be used to accurately predict the outcome of a certain response variable. Typically, a large number of variables are often collected; however, all but a few important variables are relevant for the prediction of the outcome, so the underlying representation is sparse. To this end, variable selection is fundamental in high-dimensional data analysis, playing a crucial role in important scientific discovery and decision-making, and has received enormous attention in the literature. Regularization method is one attractive approach that has …
Non-Compliance In Clinical Trials: The Perils Of Statistical Methods, Peter Drew Merrill
Non-Compliance In Clinical Trials: The Perils Of Statistical Methods, Peter Drew Merrill
All ETDs from UAB
All clinical trials must deal with protocol deviations that occur during the course of the study. One of the most important deviations is non-compliance to treatment assignment. Intention to treat (ITT) is the most commonly employed method to deal with non-compliance in a clinical trial; however, it provides biased estimates of the effect of receiving the treatment. Other methods such as per protocol (PP) and as treated (AT) provide alternatives to ITT. PP and AT, assume an all-or-nothing compliance situation. However, the possibility of being partially compliant to a treatment is common. We investigate possible approaches to incorporating partial compliance …
Development Of A Conceptual Framework For Pediatric Preparedness Healthcare Coalitions: A Pilot Study, Bryan K. Breland
Development Of A Conceptual Framework For Pediatric Preparedness Healthcare Coalitions: A Pilot Study, Bryan K. Breland
All ETDs from UAB
Natural or man-made disasters overwhelm the resources of a healthcare organization and strain or compromise the provision of medical services to rapidly expanding patient populations. Public and private healthcare organization routinely plan and exercise systems and responses intended to bolster medical care capabilities and increase the capacity of the organization during crisis events. Providers of pediatric emergency medical service are particularly vulnerable to disaster surge, since many pediatric emergency services operate consistently at near capacity. In recent years, policy-makers and medical professionals have begun to look toward healthcare coalitions as a mechanism to rapidly expand resources and capacity for patient …
Impact Of And Adoption Trends Of Hit In Cancer Care, Willi L. Tarver
Impact Of And Adoption Trends Of Hit In Cancer Care, Willi L. Tarver
All ETDs from UAB
The three discrete research projects which make up this dissertation provide empirical evidence on the impact of, and adoption trends of, health information technology (HIT) as it pertains to cancer care. The findings of these studies are important as they provide insight into the potential of HIT to improve the quality of cancer care in the US. The results of this dissertation suggest that based on the current literature, HIT interventions seem to be more successful when targeting physicians, care in the prevention phase of the cancer continuum, and/or decision making. Separately, when seeking to understand the adoption of electronic …
Exploring Body Image And The Association Between Body Image Dissatisfaction And Waist Circumference Among Overweight And Obese Rural African American Women Participating In A Weight Loss Program, Erica Rayshelle Johnson
Exploring Body Image And The Association Between Body Image Dissatisfaction And Waist Circumference Among Overweight And Obese Rural African American Women Participating In A Weight Loss Program, Erica Rayshelle Johnson
All ETDs from UAB
African American (AA) women are disproportionately burdened by obesity, an epidemic with implications that reach beyond physiological consequences. Given that perceptions of body image may impact health-promoting behaviors and weight management efforts, we sought to evaluate the presence and magnitude of body image dissatisfaction (BID) and explore its relationship with waist circumference (WC), independent of weight among overweight and obese treatment-seeking rural AA women. Participants referred to images from the Pulvers Figure Rating Scale that included nine body silhouettes to answer: “How I think I look now” (i.e., current body image) and “How I would like to look” (i.e., desired …
Prevalence And Determinants Of High Risk Human Papillomavirus (Hpv) Among Wives Of Migrant Workers - A Study In Far - West Nepal, Derek Johnson
Prevalence And Determinants Of High Risk Human Papillomavirus (Hpv) Among Wives Of Migrant Workers - A Study In Far - West Nepal, Derek Johnson
All ETDs from UAB
This dissertation research focuses on the risk factors associated with high-risk HPV infection (HR-HPV) and abnormal cervical cytology in Nepali women residing in Nepal’s Far-West district of Achham. The first part of this dissertation assesses the HR-HPV test concordance of self-collected vs. clinician-collected cervico-vaginal specimens. Of 261 women with both clinician- and self-collected cervical samples, 25 tested positive for HR-HPV, resulting in an overall HR-HPV prevalence of 9.6% (95% Confidence Interval [CI]: 6.3 – 13.8). The overall Kappa value for clinician- and self-collected tests was 0.64 (95% CI: 0.48 – 0.84), indicating a “good” level of agreement. The second part …
Statistical Methodology To Improve The Understanding Of Dna Methylation Data, Lindsay Leigh Waite Jones
Statistical Methodology To Improve The Understanding Of Dna Methylation Data, Lindsay Leigh Waite Jones
All ETDs from UAB
The study of epigenetics involves the investigation of genomic elements that do not directly affect DNA sequence but are stable and preserved during cell division. One of the most commonly studied epigenetic elements is DNA methylation, which occurs when a methyl group is added to a cytosine residue in the DNA sequence. The advancement of technology to quantify DNA methylation, including bisulfite sequencing and bisulfite microarrays, has led to a large amount of available data. However, many questions still remain as to how to statistically analyze this data. This dissertation addresses some statistical concerns related to the analysis of DNA …
Examining Parental And Neighborhood Factors As Moderators In A Youth Violence Prevention Pilot Study, Kendra Piper
Examining Parental And Neighborhood Factors As Moderators In A Youth Violence Prevention Pilot Study, Kendra Piper
All ETDs from UAB
Youth violence is a significant and prevalent public health concern in the United States. Adolescents and young adults have the highest rates of violent crime perpetration and victimization. Youth violence is a complex problem involving multiple levels of influence that interact to diminish or increase risk and protective factors in high risk communities. Family and neighborhood factors have emerged as prominent influences on the risk of violent and delinquent behavior. Approaches to reducing risk behaviors in adolescence have moved beyond traditional risk-factor reduction to emphasize the importance of enhancing protective factors. Positive youth development programs have been found to be …
The Impact Of Meal Timing On Cardiometabolic Syndrome Indicators In Shift Workers, Hylton Elisabeth Molzof
The Impact Of Meal Timing On Cardiometabolic Syndrome Indicators In Shift Workers, Hylton Elisabeth Molzof
All ETDs from UAB
Shift workers exhibit a greater risk for several cardiovascular and metabolic diseases including heart disease, obesity, hypertension, and type II diabetes (Boivin, Tremblay, & James, 2007; Chen, Lin, & Hsiao, 2010; Knutsson, Jonsson, Akerstedt, & Orth-Gomer, 1986; Kroenke et al., 2007). Shift workers have been reported to consume more pro-inflammatory diets than day workers (Wirth, Burch, Shivappa, Steck, et al., 2014) and to redistribute their food intake to the night during work (Lennernas, Hambraeus, & Akerstedt, 1995; Pasqua & Moreno, 2004). Numerous studies in animal models and humans have shown that eating during the sleep or inactive period is associated …