Digital Commons Network^™

Risk And Prognosis Of Hepatocellular Carcinoma In Mexican Americans With Type 2 Diabetes Mellitus, Rikita I Hatia, Lu-Yu Hwang, Ruosha Li, Catherine Troisi, Prasun K Jalal, Christopher I Amos, Henry F Gomez, Yun Shin Chun, Asif Rashid, Ahmed O Kaseb, Paul A Scheet, Manal M Hassan

Faculty, Staff and Student Publications

INTRODUCTION: Hepatocellular carcinoma (HCC) disproportionately affects Hispanic persons with higher age-specific incidence and increased mortality rates compared to non-Hispanic Whites. These high rates of incidence and mortality may be explained by the variation in risk factors. Given the high prevalence of type 2 diabetes mellitus (DM) among the Hispanic population, we aimed to assess the risk and prognosis of HCC in Mexican Americans with type 2 DM with consideration of treatment for DM.

METHODS: A case-control study of 241 Mexican American HCC patients and 500 healthy controls in Texas was conducted. Multivariable logistic regression analysis was performed to determine the …

A Systematic Review And Narrative Synthesis Of Factors Affecting Pre-Exposure Prophylaxis Willingness Among Black Women For Hiv Prevention, Alexis Sims Haynes, Christine Markham, Vanessa Schick, Robert Suchting, Nivedhitha Parthasarathy, Sumaita Choudhury, Mandy J Hill

Faculty, Staff and Student Publications

Pre-exposure prophylaxis (PrEP) can significantly reduce human immunodeficiency virus (HIV) transmission among Black women in the United States (U.S.), a group disproportionately affected by HIV. However, PrEP uptake in this HIV-vulnerable population is low. This review analyzes the factors influencing Black women's PrEP willingness using the Behavioral Model for Vulnerable Populations (BMVP). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Population, Intervention, Comparison, Outcome, Study Design (PICOS) framework, we conducted a systematic literature search and selected 24 peer-reviewed studies on PrEP willingness. Narrative synthesis revealed a heterogeneous landscape of the determinants affecting PrEP willingness …

Association Between Trust In The Incumbent President And Covid-19 Preventive Behaviors During The Pandemic In Four Latin American Countries, Juliana Mejía-Grueso, Gloria Isabel Niño-Cruz, Javiera Alarcón-Aguilar, Pablo Roa-Urrutia, Sergio Mauricio Moreno-López, Adriano Akira Ferreira Hino, Alexandre Augusto De Paula Da Silva, Fernando López, Deborah Salvo, Rodrigo Siqueira Reis, Guillermo Rosas, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

The COVID-19 pandemic revealed disparities in policy responses in Latin America. We examined the association between trust in the president and COVID-19 preventive behaviors in Brazil, Chile, Colombia, and Mexico. We used data from the Collaborative COVID-19 Response Survey by the McDonnell Academy at Washington University in St. Louis (United States), from September 2020 to March 2021. Nonprobabilistic sampling included adult citizens from the four countries. Multivariate negative binomial regression models were applied. The study included 8,125 participants, with Brazil showing the lowest adherence to preventive behaviors (65.5%). Increased adoption of preventive behaviors was linked with ages 18-26 (aIRR = …

A Comparison Of Floating Catchment Area Parameters With Applications To A Dataset Of Clinics Enrolled In A Statewide Child And Adolescent Psychiatric Consultation Program, Jocelyn Hunyadi, Lara S Savas, Kehe Zhang, Jeanette E Deason, Ryan Ramphul, Melissa F Peskin, Erica L Frost, Cici Bauer

Faculty, Staff and Student Publications

INTRODUCTION: Healthcare resources are often crucial but limited, requiring careful consideration and informed allocation based on population needs and potential healthcare access. In resource allocation settings, availability and accessibility of resources should be examined simultaneously. The two-step floating catchment area (2SFCA) method has been previously used to evaluate spatial accessibility to healthcare resources and services, and to address health-related disparities. The 2SFCA methods have regained significant popularity during the COVID-19 pandemic, as their application proved crucial in addressing priority public health data analysis, modeling, and accessibility challenges. However, comprehensive comparisons of the 2SFCA method input parameters in the context of …

Untargeted Metabolome Atlas For Sleep-Related Phenotypes In The Hispanic Community Health Study/Study Of Latinos, Ying Zhang, Brian W Spitzer, Yu Zhang, Danielle A Wallace, Bing Yu, Qibin Qi, Maria Argos, M Larissa Avilés-Santa, Eric Boerwinkle, Martha L Daviglus, Robert Kaplan, Jianwen Cai, Susan Redline, Tamar Sofer

Faculty, Staff and Student Publications

BACKGROUND: Sleep is essential to maintaining health and wellbeing of individuals, influencing a variety of outcomes from mental health to cardiometabolic disease. This study aims to assess the relationships between various sleep-related phenotypes and blood metabolites.

METHODS: Utilising data from the Hispanic Community Health Study/Study of Latinos, we performed association analyses between 40 sleep-related phenotypes, grouped in several domains (sleep disordered breathing (SDB), sleep duration, sleep timing, self-reported insomnia symptoms, excessive daytime sleepiness (EDS), and heart rate during sleep), and 768 metabolites measured via untargeted metabolomics profiling. Network analysis was employed to visualise and interpret the associations between sleep phenotypes …

Challenges And Opportunities Of Universal Health Coverage In Africa: A Scoping Review, Evaline Chepchirchir Langat, Paul Ward, Hailay Gesesew, Lillian Mwanri

Centre of Excellence in Women and Child Health

Background: Universal health coverage (UHC) is a global priority, with the goal of ensuring that everyone has access to high-quality healthcare without suffering financial hardship. In Africa, most governments have prioritized UHC over the last two decades. Despite this, the transition to UHC in Africa is seen to be sluggish, with certain countries facing inertia. This study sought to examine the progress of UHC-focused health reform implementation in Africa, investigating the approaches utilized, the challenges faced, and potential solutions.

Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, we scoped the literature …

Co-Creating A Social, Emotional, And Mental Health Well-Being Group For College Students With Disabilities And/Or Chronic Health Conditions And Are Registered With Disability Support Services, Consuelo A. Click Copeland

All ETDs from UAB

ABSTRACT Nearly one in four adults in the United States report living with a disability (Centers for Disease Control and Prevention, 2024). According to the National Center for Educational Statistics (2023), approximately 21 percent of undergraduate students and 11 percent of postbaccalaureate students report having a disability. Students with disabilities in college encounter considerable obstacles that can adversely affect their mental health, academic performance, and general well-being. These obstacles encompass social isolation, stigma, and insufficient personalized support services, resulting in increased levels of anxiety, depression, and dropout rates compared to students without disabilities. Despite the critical need, there is a …

Effect Of Pre-Treatment Lab-Based Comorbidities On Treatment Related Outcomes Among Patients With Cancer, Jeffrey Alan Franks

All ETDs from UAB

Cancer is one of the leading causes of mortality and morbidity in the United States. In addition to their cancer, nearly 50% of individuals have a comorbid condition. This adds complexity to the treatment of these patients as it may delay cancer diagnosis or treatment or prevent treatment all together. Lab-values are an important tool to measure comorbidities and end-organ damage as they are routinely captured as part of standard of care and the basis of clinician decision making. However, despite the widespread multimorbidity and how crucial they are to decision making, few studies assess the association of lab abnormalities …

The Impact Of Transportation Insecurity On No-Show Appointments And Acute Care Utilization In Pediatric Sickle Cell Patients, Seabrook Hannah Jeffcoat

All ETDs from UAB

Sickle cell disease (SCD) patients experience high levels of transportation insecurity. Missed or delayed medical care due to transportation barriers can result in worsened clinical outcomes and increased hospital admissions and emergency department (ED) visits. We hypothesized that the relationship between transportation insecurity and acute care utilization is partially mediated by no-show appointments. This retrospective cohort study included 101 SCD patients aged ≤ 21 treated through the Pediatric Sickle Cell Clinic at Children’s of Alabama (COA) hospital from 2023 to 2024 and completed a social determinants of health (SDoH) questionnaire. Negative binomial or Poisson regression was used to model ED …

"The Association Between Serious Psychological Distress And Life Satisfaction Among U.S Adults With Hypertension", Kellen Michael Lenz

All ETDs from UAB

Purpose: Given the observed link between psychosocial and physical health outcomes, this study investigates the association between serious psychological distress and life satisfaction among U.S adults with hypertension. Methods: A cross-sectional study using 2021 National Health Interview Survey data among U.S adults was conducted to investigate the association between serious psychological distress and hypertension and assess the role of life satisfaction in modifying this relationship. Hypertension (diagnosed, undiagnosed), serious psychological distress (≥ 13 on the Kessler 6 nonspecific distress scale), and life satisfaction (Very satisfied, Satisfied, Dissatisfied, Very dissatisfied) were self-reported by participants. Ordinal logistic regression was used to investigate …

Exploring The Impact Of Returning To Office Work Post-Pandemic On The Mental Health Of Workers: A Cross-Sectional Analysis, Jasmine M. Nelson

All ETDs from UAB

This study examines the association between work settings and mental health outcomes among Black working-aged women, with a focus on racial disparities and the role of self-care. Using data from the U.S. Census Bureau's 2024 Household Pulse Survey, this cross-sectional analysis includes responses from 196,293 employed women aged 18–65. Mental health outcomes, including anxiety, worry, lack of interest, and depressive symptoms—were assessed through self-reported measures. Work settings were categorized as telework (hybrid/remote) or in-office, and logistic regression models were used to assess associations between work setting and mental health outcomes, adjusting for demographic and socioeconomic factors. Findings indicate that Black …

Epidemiologi Kejadian Luar Biasa Malaria Bulan September-November 2024: Studi Serial Kasus Di Kabupaten Indragiri Hilir, Provinsi Riau, Rajunitrigo Rajunitrigo, Irwan Muryanto, Renti Mahkota, Fadhil Armen, Yusni Nuryanti, Fahrul Rizal, Rabiatul Adwiyah

Jurnal Epidemiologi Kesehatan Indonesia

Abstract

Malaria remains a public health issue in Indragiri Hilir Regency, Riau, despite its elimination certification 2018. In 2024, a malaria outbreak occurred, and an epidemiological investigation was then carried out. This study aims to describe the epidemiological characteristics of the malaria outbreak based on person, time, and place. This study used a serial case design, analyzing all confirmed malaria cases reported in the e-SISMAL system of Indragiri Hilir Regency from September 1^st to November 30^th, 2024. Data on Anopheles Sundaicus habitats were obtained from epidemiological investigation reports. Univariate and bivariate analyses were conducted using the chi-square …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Skin Carotenoid Levels And Dermatologic Diseases, Taylor Schwarz, Sidney Smith, Eric Shaw, Adam Ginensky, Nikki Dixon, Patricia Mercado

South Atlantic Division GME Research Day 2025

No abstract provided.

Education Interventions Implemented To Increase Lung Cancer Screening Rates, Arpit Arora, Crystal Bharat, Sophia Zia, Pooja Paunikar, Dana Simpson

South Atlantic Division GME Research Day 2025

No abstract provided.

Self-Inflicted, Non-Sexual, Non-Masturbatory Penile Fracture Case Report - An Atypical Presentation, Sajan Sehgal, Vijayakumar R, Sachin Dharwadkar, Amruthraj G. Gowda

Digital Journal of Clinical Medicine

Background: Traumatic injuries to the genitalia are uncommon due to the mobility of the penis and scrotum. Penile fracture is a relatively rare condition arising from disruption of tunica albuginea with rupture of the corpus cavernosum. In order to ensure that such an injury is not missed, it is necessary to have a high index of suspicion to diagnose this condition.

Result: Patient underwent an emergency repair of penile fracture.

Conclusion: We hereby, report a rare case of accidental, non-masturbatory, self-inflicted penile fracture which was diagnosed promptly based on clinical assessment, confirmed radiologically and managed surgically, resulting …

Evaluating The Efficacy Of Vertical Integration In Training Undergraduate Medical Students Under Competency Based Medical Education Curriculum, Pratham Mehta, Yashika Sharma, Kishor M, Arun M

Digital Journal of Clinical Medicine

Background: The National Medical Council in the Indian Medical Graduate guidelines to enhance learning, recommends Vertical and Horizontal Integration. Vertical integration may be defined as a curricular strategy that aligns para-clinical and clinical teaching across time with a view to enhancing relevance and application of knowledge. The present study is an attempt to test whether vertical integration of Forensic Medicine and Psychiatry is associated with greater short-term learning gains and improved student perceptions compared with conventional didactic lectures.

Methods: With Institutional and Ethics Committee clearance, a two-phase quasi-experimental study was performed across two consecutive academic cohorts (Phase 1, …

All About Over-The-Counters: The Use Of Public Health Principles In Health Education, Himanshu Gandhi

Honors Program: Senior Projects (Public)

The transition from high school to college can be extremely tough on students. There is a massive restructuring in schedules, academics, social lives, and even health. While many students come to college prepared to tackle their respective majors and courses, many of them aren’t prepared to handle the challenges of independent living. One of these challenges is self-healing and preventative care. As part of the University Honors Program, I have had the privilege of taking the first step of many in tackling this challenge. My project consisted of researching several common over-the-counter medications, utilizing my pharmaceutical and biochemical background to …

Approval Of Parent-Child Aggression As A Mediator Of Intergenerational Child Abuse Risk: An Evaluation Of Racial Differences, Casie H. Morgan, Christina M. Rodriguez, Doris F. Pu, Zoe O. Elkins

Psychology Faculty Publications

Purpose

Personal history of parent-child aggression (PCA) can predict future parenting behavior, but some effects may differ between racial groups. Black parents in the U.S. are more likely to encounter discrimination and personally experience and approve of PCA, which may account for previously reported group differences. This study examined whether personal PCA history predicted later parental child abuse risk mediated by PCA approval across the transition to parenthood, and whether effects differed by race.

Methods

Expectant parents (non-Hispanic White sample: 95 mothers with 86 fathers; Black sample: 94 mothers with 85 fathers) participated in a prospective longitudinal study, assessed prenatally …

Exploring Differences In Cannabis Use And Harm Perceptions Among Sexual Minority And Heterosexual Females: A Brief Report, Sarah J. Ehlke, Samantha A. Fitzer, Kendra Rigney

Psychology Faculty Publications

Objective: Sexual minority women (SMW) have higher rates of cannabis use compared to heterosexual women, which may be partially attributed to lower harm perceptions. However, no study has examined if the association between harm perceptions and cannabis use is stronger for SMW than heterosexual women. This study examined if sexual identity (SMW vs. heterosexual woman) moderated the association between harm perceptions and past 30-day cannabis use among a sample of female young adults (18-25 years old). Method: Participants were 949 (29.8% SMW; Mean age = 24.33; 92.1% non-Hispanic White) females (99.3% cisgender) recruited from Amazon Mechanical Turk who reported weekly …

Psychometric Evaluation Of A Novel Measure Of Trauma-Related Cannabis Use To Cope, Sage E. Hawn, Terrell A. Hicks, Christopher Latourrette, Anita Thomas, Daniela Chaname, Sarah Ehlke, Abigail Powers Lott

Psychology Faculty Publications

Background: Posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) are commonly comorbid and are associated with many negative public health outcomes. One plausible explanation for this comorbidity comes from a self-medication framework, which suggests people use cannabis to cope with PTSD symptoms. Despite theoretical and empirical evidence for PTSD-related cannabis use to cope, no measure of this construct exists.

Objective: We sought to address this gap by developing and validating a novel measure of PTSD-specific cannabis self-medication, which we have termed the Trauma-Related Cannabis Use to Cope (TRCU) questionnaire.

Method: The psychometric properties of the TRCU and how it …

Willingness To Use Long-Acting Injectable Pre-Exposure Prophylaxis (Lai-Prep) Among Black Cisgender Women In The Southern United States, Sylvia Shangani, Jaquetta M. Reeves, Kristin Heron, Jessica M. Sales, Kenneth K. Mugwanya

Psychology Faculty Publications

Background

Long-acting injectable pre-exposure prophylaxis (LAI-PrEP) for HIV prevention may improve adherence for those with concerns with daily pills. Limited data exist on LAI-PrEP acceptability among Black women in the U.S., a population vulnerable to HIV. We assessed willingness to use LAI-PrEP among Black women eligible for PrEP in the Southern U.S.

Methods

We conducted a cross-sectional online survey of HIV-negative Black women from March to June 2022 in the U.S. South. Participants provided information on sociodemographic characteristics, HIV knowledge, PrEP awareness, and use, stigma, risk perception, medical mistrust, and healthcare access. Multivariate logistic regression models determined factors associated with …

Evaluation Of A 20-Item Version Of The Trauma-Related Drinking To Cope Questionnaire, Sage E. Hawn, Lauren Smith, Kaytlin Armitage, Selah Ball, Cathy Lau-Barraco, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Objectives: This study sought to develop and psychometrically evaluate an expanded version of the Trauma-Related Drinking to Cope (TRD) scale, a four-item self-report tool, which was developed to address a crucial gap in self-medication research. Before the development of the TRD, no measures existed which assessed alcohol use for coping with symptoms of posttraumatic stress disorder (PTSD) specifically. Previous work showed that the TRD has strong psychometric properties and clinical utility in its ability to identify individuals with PTSD who may be at risk for developing comorbid alcohol use disorder (AUD). The aim of the present study was to develop …

A Multilevel Framework For The Promotion Of Maternal Mental Health And Well-Being During The Perinatal Period, Jenn A. Leiferman, Jessica Walls Wilson, Charlotte V. Farewell, Chelsea Walker-Mao, James F. Paulson

Psychology Faculty Publications

Background: Depression and anxiety are prevalent in the perinatal period and may contribute to adverse maternal and child health outcomes. A focus on multilevel protective factors may be effective in promoting well-being and increasing quality of life (QOL) in the perinatal period while simultaneously reducing or preventing depression and anxiety symptoms. We tested a conceptual model that posits specific personal, social, and community factors affecting depression, anxiety, and QOL among pregnant and postpartum individuals.

Methods: Four hundred and thirty-eight pregnant or postpartum individuals completed a 121-item cross-sectional survey composed of validated tools that assessed multilevel protective factors, health behaviors, and …

Drone-Based Medication Delivery For Rural, Flood-Prone Coastal Cities, Yin-Hsuen Chen, Amro M. El-Adle, Kevin J. O'Brien, Taylor Wentworth, Heather G. Richter

Center for Geospatial Science, Education & Analytics Faculty Publications

Access to healthcare remains a critical challenge for rural populations, particularly in flood-prone coastal communities where transportation barriers limit access to essential medical services. This study evaluates the effectiveness of drone-based medication delivery in improving healthcare accessibility for vulnerable populations on Virginia’s Eastern Shore. Compared to traditional personal vehicle travel, drone delivery reduced trip times from up to 50 minutes to under 10 minutes for more than 80% of the population, including elderly patients. Using publicly available datasets, we developed two transportation vulnerability indices that incorporate age, travel time, and flood risk to prioritize patients for drone-based pharmaceutical delivery. These …

High-Resolution Modeling Of Extreme Heat Events With Socioeconomic Consideration: A Real-Case Wrf-Les Approach, Maryam Golbazi, Frank Liu, Yin-Hsuen Chen, Timothy W. Juliano, Heather Richter

ODU Articles

The overarching goals of this work is to explore best practices for micro-scale modeling of a real case, identify relevant phenomena by using high-resolution modeling, and to explore their implications for public health, and climate resilience strategies in Hampton Roads, VA, USA. This project employs the Weather Research and Forecasting (WRF) model to conduct a comprehensive study of Hampton Roads, utilizing a coupled mesoscale to microscale modeling capable of resolving boundary layer turbulence. This study has three primary objectives: (1) to establish the optimal mesoscale to Large-Eddy Simulation (LES) configurations for complex geographical regions such as the Hampton Roads (HR) …

'I Did Not Know We Could Exercise This Small Premature Baby': Challenges Experienced By Parents While Implementing Early Intervention For Their Preterm Infants-A Qualitative Perspective, Manasa Kolibylu Raghupathy, Selim Jahangir, Sonia Khurana, Leslie Edward S. Lewis, Bhamini Krishna Rao

Rehabilitation Sciences Faculty Publications

Background

Preterm birth is a highly stressful experience for both parents and infants. Parental participation in care enhances developmental outcomes, fosters parent-infant interactions and builds parental confidence. However, low parental adherence has always been a challenge in the successful implementation of intervention programs both in the NICU and at home. It is imperative to understand parents' perspectives and view the challenges that they experience through their lens while providing early intervention to their infants born preterm. This study is aimed at identifying new parents' challenges when implementing early intervention programs for their infants during the transition from hospital to home. …

Therapy-Based Strategies To Support Tummy Time In Infants Post-Hospital Discharge: A Scoping Review Protocol, Ketaki Inamdar, Sonia Khurana

Rehabilitation Sciences Faculty Publications

Tummy time is essential for infant development, yet many caregivers face significant challenges with adherence due to behavioral and contextual barriers. While numerous tummy time interventions exist, a limited understanding of their behavioral components hinders effective replication and implementation. This scoping review aims to identify multidisciplinary interventions used to promote tummy time in infants aged 0–12 months, evaluate their impact on adherence, developmental and health outcomes, and examine the behavior change techniques employed using the Theoretical Domains Framework (TDF). Following the Joanna Briggs Institute (JBI) methodology, a comprehensive search will be conducted in MEDLINE (PubMed), Web of Science Core Collection, …

Frequency And Perceived Influence Of Menopausal Symptoms On Training And Performance In Female Endurance Athletes, Heather M. Hamilton, Natalie M. Yarish, Kristin E. Heron

Rehabilitation Sciences Faculty Publications

Menopause is associated with several negative health concerns and common menopausal symptoms. Physical activity is essential to mitigate these negative effects, but menopausal symptoms may interfere with participation in physical activity. The purpose of this study was to determine the frequency and the perceived negative effect of menopausal symptoms among female endurance athletes. Female runners, cyclists, swimmers, and triathletes 40–60 years of age were recruited (N = 187). Participants completed an online, anonymous survey that included self-reported menopausal status; the Menopausal Rating Scale (MRS), a validated measure for assessing menopausal symptoms; and the perceived effect of menopausal symptoms on …

Laboratory Investigation Of Shape And Initial Orientation Effects On Surf Zone Object Migration, Temitope E. Idowu, Jack A. Puleo

Civil & Environmental Engineering Faculty Publications

Discarded objects like munitions in marine environments pose public safety risks. The behavior of various density objects deployed at four cross-shore positions in the surf zone of a large-scale 120 m x 5 m x 5 m wave flume were observed under different forcing conditions. Net migration was predominantly directed offshore, with approximately 70 % offshore migration observed near the outer surf zone. Density, shape, and initial orientation were identified as important to object behavior, with density acting as the dominant driver in 67 % of the object pairing scenarios. The influence of shape and initial orientation on net migration …