Digital Commons Network^™

A Novel Bayesian Spatial-Temporal Approach To Quantify Sars-Cov-2 Testing Disparities For Small Area Estimation, Cici Bauer, Xiaona Li, Kehe Zhang, Miryoung Lee, Esmeralda Guajardo, Susan Fisher-Hoch, Joseph Mccormick, Maria E Fernandez, Belinda Reininger

Faculty, Staff and Student Publications

Objectives. To propose a novel Bayesian spatial–temporal approach to identify and quantify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing disparities for small area estimation.

Methods. In step 1, we used a Bayesian inseparable space–time model framework to estimate the testing positivity rate (TPR) at geographically granular areas of the census block groups (CBGs). In step 2, we adopted a rank-based approach to compare the estimated TPR and the testing rate to identify areas with testing deficiency and quantify the number of needed tests. We used weekly SARS-CoV-2 infection and testing surveillance data from Cameron County, Texas, between March 2020 …

From The National To The Local: Issues Of Trust And A Model For Community-Academic-Engagement, Olufunmilayo Chinekezi, Lauri Andress, Etsemaye P Agonafer, Susan Massick, Sarah Piepenbrink, Karey M Sutton, Philip M Alberti, Desiree De La Torre, Shannon Guillot-Wright, Marshala Lee

Faculty, Staff and Student Publications

Inequities in health and health care in the United States have persisted for decades, and the impacts on equity from the COVID-19 pandemic were no exception. In addition to the disproportionate burden of the disease across various populations, the pandemic posed several challenges, which exacerbated these existing inequities. This has undoubtedly contributed to deeply rooted public mistrust in medical research and healthcare delivery, particularly among historically and structurally oppressed populations. In the summer of 2020, given the series of social injustices posed by the pandemic and highly publicized incidents of police brutality, notably the murder of George Floyd, the Association …

A Case Of Successful Treatment Of Recurrent Urinary Tract Infection By Extended-Spectrum Β-Lactamase Producing, Naomi Bier, Blake Hanson, Zhi-Dong Jiang, Herbert L Dupont, Cesar A Arias, William R Miller

Faculty, Staff and Student Publications

Recurrent urinary tract infections (UTIs) are a challenging clinical entity that can be frustrating for patient and physician alike. Repeated rounds of antibiotics can select for multidrug-resistant organisms, further complicating care. We describe the successful use of fecal microbiota transplantation (FMT) for the treatment of recurrent extended-spectrum β-lactamase (ESBL)-producing

Genetic And Epigenetic Risk Scores For Chronic Kidney Disease In African Americans, Alana C. Jones

All ETDs from UAB

Kidney disease is the tenth-leading cause of death in the United States (US). There are significant racial disparities within kidney disease: African Americans (AAs) have the highest rates of CKD and carry a four-fold higher risk of developing end-stage renal disease (ESRD). They are also less likely to undergo kidney transplants, and among those who do, are more likely to experience graft rejection. Additionally, until 2021, kidney function equations were shown to underestimate the severity of kidney disease in AA due to the use of race coefficients. Among all populations, genetic and epigenetic factors contribute to kidney disease. However, AAs …

The Effect Of Weather Events On Dengue Fever In Brazil 2014-2022, Maryclare Gabel

All ETDs from UAB

Dengue fever is a mosquito-borne infectious disease that is spread through the bite of an infected Aedes aegypti or Aedes albopictus mosquito. Half the world's population lives in a dengue fever risk zone. There are an estimated 100 million symptomatic dengue fever cases each year, with 40,000 deaths reported. Brazil reports the highest annual dengue fever cases in Latin America. In 2022, Brazil recorded 2.36 million dengue fever cases, the highest number of cases ever recorded in the country. We designed a retrospective ecological study to evaluate the temporal trends and the association between weather events and dengue fever incidence …

Temporal Trends In Tularemia Incidence In The United States From 2010 To 2020. Are Age And Sex Associated With These Changing Trends?, Carla V. Brooks

All ETDs from UAB

Background: Tularemia or Rabbit Fever was discovered in 1911 in a plague-like outbreak among rodents in Tulare County, California. Tularemia in the US has expanded from rural to more metropolitan areas, which may be potentially correlated with the escalating exposure of humans to animal vectors. There has not been a recent study evaluating trends in Tularemia, especially one that has evaluated if the trends in Tularemia over time differ by demographic characteristics. Methods: This is an ecological study to evaluate the temporal trends and if trends Tularemia incidence over time differs by age and sex in the United States from …

Antimicrobial Resistance In Type Ii Diabetic Patients In Southeastern U.S., Onyebuchi Angela Elegede

All ETDs from UAB

Background: In the Southern and Appalachian regions of the United States, antibiotic prescription rates surpass the national average, coinciding with a higher prevalence of Type II diabetes (DM2). Although international research has previously described the correlation between DM2 and increased risk of antimicrobial-resistant (AMR) infections, comprehensive studies on this relationship are lacking in the U.S. The objective of this study was to investigate the association between AMR infections and DM2 and examine the association in two DM2 positive racial groups. This study also examined the differences in the prevalence of clindamycin resistance of methicillinresistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus …

Social Vulnerability And Trust Associated With African American Secondary Syphilis Cases Reported In Alabama, United States, 2020-2022, Givanta Tribit

All ETDs from UAB

Introduction: Syphilis is a sexually transmitted infection (STI) that can cause serious health problems, including neurological disorders, blindness, and fetal abnormalities. Routine STI screenings can help prevent its spread. Despite effective treatments, syphilis cases have risen sharply in the last decade, particularly among marginalized communities. Understanding the ecological and contextual factors contributing to syphilis incidence could inform prevention efforts and improve healthcare outcomes for all. Methods: Retrospective secondary data analyses, at the county level, from 2020 to 2022, were conducted to assess for mean differences among social vulnerability index (SVI) scores, SVI scores by four primary categories, Black Belt regional …

Association Between Covid-19 Health Knowledge, Self-Efficacy And Preventive Behaviors Among Nursing Students, Josephine Miane Britanico

Walden Dissertations and Doctoral Studies

Abstract Nursing students possess valuable public health knowledge to prevent the spread of COVID-19 infection. They can provide health education to the public with reliable information and adequate resources. To better understand the role nursing students can take in prevention efforts, the purpose of this quantitative correlational study was to examine the association between COVID-19 health knowledge, self-efficacy, and preventive behavior among undergraduate nursing students. The health belief model was the theoretical framework that guided this study. The primary research questions assessed (a) if there was a statistically significant association between COVID-19 health knowledge and preventive behavior among nursing students, …

Navigating Missed Visits In Hiv Primary Care: Exploring Risk Factors Associated With Missed Visits, Jiaying Hao

All ETDs from UAB

The HIV care continuum is a public health model that outlines the steps or stages people with HIV go through from diagnosis to achieving and maintaining viral suppression. Retention in care, a key component of the HIV care continuum, is critical in achieving good health outcomes for people with HIV (PWH) and preventing HIV transmission. Consistent HIV care is essential for the health of PWH as a part of retention in care. De-spite no standard measure for retention in care to PWH, the missed (no-show) vis-its/appointments is one of the most commonly used methods for evaluating retention in HIV care. …

The Geographic Pattern And Socioecological Factors Of Helicobacter Pylori Infections In The United States, Judith Ann Merryweather

Walden Dissertations and Doctoral Studies

AbstractHelicobacter pylori (H. pylori) is one of the most common human pathogens and may play a role in the development of several distinct diseases, which include gastric ulcer, duodenal ulcer, and gastric cancer. Studying geographic territories of the United States may reveal clusters with high rates of H. pylori infection and perhaps the prevalence of gastric cancer; however, geographic mapping of patterns in the United States is scarce. The purpose of this study was to investigate changes in H pylori infection patterns in the United States between two different time points (2000–2002 and 2016–2018). The primary hypotheses of this study …

Moderators Of Peripheral Neuropathy On Overall And Cardiovascular Mortality In People Without Diabetes, Adeoye Muideen Adenekan

Walden Dissertations and Doctoral Studies

Peripheral neuropathy (PN), a group of common heterogeneous disorders with varied etiologies, is associated with substantial morbidity and mortality. PN presents both as a diagnostic and therapeutic challenge to physicians and other healthcare providers. Socioeconomic moderators of PN in adults without diabetes in the United States have not been well studied. The consequences of PN can be devastating and include foot ulcers, amputations, a general decline in the quality of life, and death. The overall prevalence of PN in the United States is 13.5% in adults with diabetes and 11.6% in adults without diabetes. Clearly, these statistics indicate a public …

Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi

Walden Dissertations and Doctoral Studies

Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …

Examination Of The Association Between Poverty, Income, And Education Levels On Tuberculosis Prevalence In Nigeria: Rural Niger Delta Case Study, Nwinmene George Zarakpege

Walden Dissertations and Doctoral Studies

Despite the global decline in tuberculosis (TB) cases, the prevalence of TB in rural populations in Nigeria is rising. To date, poverty and low educational levels continue to affect treatment and other prevention strategies to eradicate the disease. The purpose of this cross-sectional study was to assess the association between poverty, educational levels, household structure and vaccination status on TB prevalence in rural Niger Delta, Nigeria. The theoretical framework for this study was the socio-ecological model. Data were obtained from residents of rural Niger Delta in Nigeria attending a teaching hospital in southern Nigeria. The relationship between the stated demographic …

Associations Between Depression, Social Support, And Sexual Risk-Taking Behaviors Among Hiv-Infected Adult Black Women In The Southeastern United States, Joy Ireri Kagendo

Walden Dissertations and Doctoral Studies

African Americans continue to carry the burden of new HIV cases and sexually transmitted infections and other comorbidity health problems more than any other social group in the United States. Except for New York; Washington, DC; and Maryland, 65% of all new HIV cases are in the Southern states. The U.S. Southern states make up 38% of the U.S. population, yet approximately 51% of annual HIV diagnoses are from the Southern U.S. states. In the Southern states, AIDS is among the leading cause of death for African American women. A gap exists in the associations of depression, social support, and …

Association Between Dietary Phytoestrogen Intake And Xenoestrogen Exposure And Estrogen-Dependent Cancers, Pisita Bolsue

Walden Dissertations and Doctoral Studies

The role of circulating estrogens and the impact of lifetime exposure to multiple sources of exogenous estrogens as factors in carcinogenesis were not well understood. Research showed conflicting results when dietary phytoestrogen (PE) intake and xenoestrogen (XE) exposure occurred independently and when co-exposed. The purpose of this quantitative cross-sectional study was to investigate the association between dietary PE intake and XE exposure and the development of estrogen-dependent cancers in an epidemiological context. The advanced model of the epidemiology triangle was the theoretical framework for the current study in which binary logistic regression was employed on secondary data from the 2003–2006 …

Associations Between Socioecological Factors And Breastfeeding Duration Among Obese Mothers In Mississippi, Maria Mercedes Miranda Porter

Walden Dissertations and Doctoral Studies

There is a growing obesity pandemic in the United States. Low breastfeeding duration rates and socioecological factors lead to obesity in the most southern states. Overweight and obese breastfeeding mothers have not been primarily studied. There is mixed information regarding duration of breastfeeding, BMI, and heart health, as well as a lack of quantitative analyses involving reducing obesity rates in mother-child dyads. The purpose of this quantitative cross-sectional study was to investigate whether there were any associations between breastfeeding duration and BMI, heart health problems, breastfeeding support, and eating and exercise among Mississippi overweight and obese postpartum women based on …

Influences On Influenza Vaccine Uptake Among Older Lebanese Adults, Doha D'Agostini

Walden Dissertations and Doctoral Studies

Influenza is a viral infection that is globally transmitted and that increases the risk for infectious diseases, hospitalization, and morbidity and mortality, especially among the older adult population. Although influenza vaccines are recommended in several countries, influenza vaccine hesitancy remains a challenge. In Lebanon, there is minimal research related to older adults’ attitudes and perceptions associated with influenza vaccination. To explore older Lebanese adults’ vaccination experiences and perceptions of the factors that affect their influenza vaccine uptake, a qualitative investigation was conducted. The theory of planned behaviors served as the theoretical framework for the study. A thematic analysis was conducted …

Risk Factors Of Human Papillomavirus Positive Oropharyngeal Cancer In Men, Kentress Davison

Walden Dissertations and Doctoral Studies

The human papillomavirus (HPV) is a leading domestic and global sexually transmitted disease. The purpose of this secondary quantitative, cross-sectional study is to investigate if there is an relationship between the rate of oral HPV-oropharyngeal squamous cell carcinoma (OPSCC) and race, exposure to smoking cigarettes (tobacco), risky sexual behavior, and participation in oral sex of male-to-male contact vs. male-to-female contact. The social cognitive theory grounded this study. The University of Alabama at Birmingham cancer database population supplied the study’s sample size of 337 males greater than 18 years of age with a diagnosis of OPSCC. I conducted descriptive analyses using …

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …

Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey

Walden Dissertations and Doctoral Studies

Native Americans in the Northern Plains have a long history of tuberculosis (TB) infections. There is limited research on the causes of latent TB infections (LTBI) and TB in this population. The purpose of this quantitative study was to assess the relationship between latent TB and factors of homelessness, substance use, employment, living on a reservation, and active or latent TB among this population using the eco-social theory as the theoretical framework. Data from 146 TB cases of Native Americans living in the Northern Plains and diagnosed with TB from 1999 to 2019 were analyzed using chi-square tests that showed …

The Relationship Between Chlamydia, Gonorrhea, Syphilis And Race, Gender, And Age, Johnny James Mcgrew

Walden Dissertations and Doctoral Studies

The purpose of this quantitative correlational design using secondary data from Colorado Department of Public Health and Environment was to examine the relationship between different types of sexually transmitted infections (STIs), specifically, chlamydia, gonorrhea, and syphilis, and race, gender, and age in the United States. This study is significant because it could assist medical personnel to focus on more personally-based STI treatments. This study could also lead to a call for more research regarding sexual health programs across the nation, individuals’ willingness to share personal information regarding STIs, and how sexual health programs could increase testing for STIs. The study …

Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic remains a global health challenge, with 6.7 million deaths worldwide as of January 2023. It has illuminated the health iniquities in underserved communities and populations like those with sickle cell disease (SCD). Researchers have associated the COVID-19 outcome among SCD patients in other regions of the globe. The purpose of this retrospective cross-sectional observational study was to investigate the relationship between age, race/Hispanic origin, and COVID-19 mortality among persons with SCD in the United States from January 2020 to March 2021. The Krieger ecosocial theory of disease distribution framed the study. Data were drawn from an existing …

An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson

Walden Dissertations and Doctoral Studies

s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated …

A Quantitative Study On Molecular Cluster Detection In Virally Suppressed Communities, Mariska Belinda Osborne-Wells

Walden Dissertations and Doctoral Studies

Viral suppression within human immunodeficiency virus (HIV) care and treatment planning is the gold standard of care for most providers when engaging with their patients. In many settings, the patient has received a positive lab that is indicative of HIV antibodies being detected; this in turn means they need additional medical attention to manage the infection. Upon receiving linkage to care services and attending an initial appointment, an initial genetic sequence is usually completed to assess the patient’s strain of HIV and how antiretroviral medications may antagonize or complement the HIV strain. It is possible that access, bias, and colorism …

Association Between Covid-19 Health Knowledge, Self-Efficacy And Preventive Behaviors Among Nursing Students, Josephine Miane Britanico

Walden Dissertations and Doctoral Studies

Abstract Nursing students possess valuable public health knowledge to prevent the spread of COVID-19 infection. They can provide health education to the public with reliable information and adequate resources. To better understand the role nursing students can take in prevention efforts, the purpose of this quantitative correlational study was to examine the association between COVID-19 health knowledge, self-efficacy, and preventive behavior among undergraduate nursing students. The health belief model was the theoretical framework that guided this study. The primary research questions assessed (a) if there was a statistically significant association between COVID-19 health knowledge and preventive behavior among nursing students, …

A Quantitative Study On Molecular Cluster Detection In Virally Suppressed Communities, Mariska Belinda Osborne-Wells

Walden Dissertations and Doctoral Studies

Viral suppression within human immunodeficiency virus (HIV) care and treatment planning is the gold standard of care for most providers when engaging with their patients. In many settings, the patient has received a positive lab that is indicative of HIV antibodies being detected; this in turn means they need additional medical attention to manage the infection. Upon receiving linkage to care services and attending an initial appointment, an initial genetic sequence is usually completed to assess the patient’s strain of HIV and how antiretroviral medications may antagonize or complement the HIV strain. It is possible that access, bias, and colorism …

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …

Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic remains a global health challenge, with 6.7 million deaths worldwide as of January 2023. It has illuminated the health iniquities in underserved communities and populations like those with sickle cell disease (SCD). Researchers have associated the COVID-19 outcome among SCD patients in other regions of the globe. The purpose of this retrospective cross-sectional observational study was to investigate the relationship between age, race/Hispanic origin, and COVID-19 mortality among persons with SCD in the United States from January 2020 to March 2021. The Krieger ecosocial theory of disease distribution framed the study. Data were drawn from an existing …

Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi

Walden Dissertations and Doctoral Studies

Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …