Digital Commons Network^™

Statistical Methods For Evaluating Confounding In Nutritional Epidemiology: Examining The Association Of Dietary Measures And Incident Type 2 Diabetes, Stephanie E. Tison

All ETDs from UAB

Nutrition is a key factor in the development of noncommunicable diseases (NCDs) such as cardiovascular disease, diabetes, obesity, and cancer, which are continuing to increase globally. Research on dietary patterns is crucial for informing what aspects of diet are most critical for preventing and possibly reversing chronic disease. Dietary patterns focus on the types of food that are consumed which reflects the complexity and cultural aspects of diet rather than focusing on a single food or nutrient. Observational cohort studies are able to observe typical dietary intake and thus better reflect the real association between diet and chronic disease. In …

Cardiovascular Disease Risk In Head Neck Squamous Cell Carcinoma Patients: Using Electronic Medical Records Data, Amrita Mukherjee

All ETDs from UAB

The objective of my dissertation research was to assess burden of cardiovascular disease (CVD) risk factors in Head Neck Squamous Cell Carcinoma (HNSCC) patients and to determine the association of traditional CVD risk factors and HNSCC-related factors with incident CVD outcomes. For this clinical cohort study, I analyzed electronic medical records (EMR) and tumor registry data on HNSCC patients diagnosed between January 2012 and December 2018 at UAB hospital and O’Neal Comprehensive Cancer Center. First, I assessed prevalence and incidence of traditional CVD risk factors at HNSCC diagnosis (baseline) and at one-year post HNSCC diagnosis, respectively. Then I determined the …

An Investigation Of Strain And Support Needs Of Caregivers Of Older Adults With Delirium And Allied Health Promotion Interventions, Jasmine Vickers

All ETDs from UAB

Delirium, or the sudden onset of confusion, is common, highly distressing, debilitating, and deadly among hospitalized older adults and is associated with adverse outcomes for their family caregivers. As people are living longer with more complex conditions, more people will face the task of caregiving for older adults with delirium. Family caregivers can make meaningful contributions to delirium care, but high distress, insufficient knowledge, and lack of skills often seen in caregivers can lead to maladaptation and negative health outcomes. A few studies have focused on distress in caregivers from witnessing delirium episodes; however more research is needed to understand …

Cognitive Progression And Care Patterns In All-Cause Dementia By Prior Cancer Diagnosis, Mackenzie Elisha Fowler

All ETDs from UAB

Cancer and dementia are common aging-related diseases. Cancer and itstreatments are associated with cognitive impairment referred to as cancer-related cognitive impairment (CRCI). Dementias demonstrate similar impairment. Only one study has examined the longitudinal association between cancer and dementia. This dissertation goes beyond limitations of the prior study and has three aims: 1.) to evaluate dementia progression by prior cancer diagnosis, 2.) to evaluate progression of all-cause dementia by cancer treatments, and 3.) to evaluate patterns and predictors of care among dementia patients by cancer history. This study uses EHR data to evaluate cognitive progression by cancer history /cancer treatment characteristics, …

Seaweeds Polysaccharides In Active Food Packaging: A Review Of Recent Progress, Carina Dietz, Shubham Sharma, Amit Jaiswal, Swarna Jaiswal

Articles

Background

Due to its short lifetime, food packaging leads to a rapid accumulation of plastic in our surroundings and thereby also has a huge impact on environmental pollution. To reduce these effects and create a more sustainable approach towards food packaging, biodegradable and biobased polymers have been developed and are emerging on the market.

Scope and approach

This review provides the current state of research regarding active packaging and the incorporation of seaweed into food packaging. Further, it summarises the resulting consequences of the seaweed incorporation on mechanical, physical, thermal, antioxidant, antimicrobial, and chemical properties, as well as the release …

The Role Of Race, Sex, And Place In The Association Of Diabetes And Cardiovascular Disease, Gargya Malla

All ETDs from UAB

Cardiovascular disease risk is higher among adult with diabetes than those without diabetes. This increase in risk may vary by race, sex, and neighborhood characteristics. Recent US data showed a resurgence in stroke and coronary heart disease (CHD) among adults with diabetes, and an increase in heart failure (HF) mortality. Therefore, this dissertation investigated how cardiovascular disease risk may vary by race, sex, and neighborhood characteristics for adults across the glycemic spectrum.Data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, an ongoing prospective cohort of 30,239 Black and White adults age 45 years at baseline (2003-07) …

Risk Of Delirium With Opioid Use Among Older Adults In The Emergency Department, Rachel Michelle Skains

All ETDs from UAB

Objectives: Delirium affects 7-17% of older Emergency Department (ED) patients. Inadequate pain control and opioid pain management have been reported to increase risk for delirium. The aim of this study was to evaluate the association between pain severity, opioid exposure, and delirium among older ED patients.Methods: A single-center retrospective cohort study was conducted in an academic Geriatric ED. Patients aged ≥65 years with an Identification of Seniors at Risk (ISAR) score ≥2 and an Emergency Severity Index (ESI) level 3 were enrolled into the Geriatric ED Pathway. Those who received a delirium screening using the Nursing Delirium Screening Scale (NuDESC) …

Association Of Abdominal Obesity And Risk Of Atrial Fibrillation: Findings From The Reasons For Geographic And Racial Differences In Stroke (Regards) Study, Joonseok Kim

All ETDs from UAB

Background: Our knowledge of the association between abdominal obesity (AO) and the risk of atrial fibrillation (AF) after adjusting for body mass index (BMI) is limited. Methods: We included 11,617 black and white participants (mean age 63.0 + 8.4 years) from the REGARDS (REasons for Geographic and Racial Differences in Stroke) national cohort study who were free of AF at baseline between 2003 and 2007, and completed a follow-up exam between 2013 and 2016 with assessment of AF. A multivariable logistic regression model was used to estimate the odds ratio (OR) with 95% confidence interval of incident AF associated with …

The Influence Of Sunlight Exposure And Sun Protecting Behaviours On Allergic Outcomes In Early Childhood, Kristina Rueter, Anderson P. Jones, Aris Siafarikas, Paola Chivers, Susan L. Prescott, Debra J. Palmer

Research outputs 2014 to 2021

The dramatic rise in allergic disease has occurred in tandem with recent environmental changes and increasing indoor lifestyle culture. While multifactorial, one consistent allergy risk factor has been reduced sunlight exposure. However, vitamin D supplementation studies have been disappointing in preventing allergy, raising possible independent effects of ultraviolet (UV) light exposure. The aim of this study was to examine whether UV light exposure influences the development of allergic disease in early childhood. Direct sunlight exposure (290–380 nm) in early infancy was measured via UV dosimeters. Outdoor exposure, sun protective behaviours, and allergy outcomes were assessed over the first 2.5 years …

The Missing Link Between Medical Science Knowledge And Public Awareness: Implications For Tourism And Hospitality Recovery After Covid-19, Jun Wen, Haifeng Hou, Metin Kozak, Fang Meng, Chung-En Yu, Wei Wang

Research outputs 2014 to 2021

Purpose: As the world grapples with the pervasive effects of the coronavirus pandemic, a notable disconnect has emerged in the public's understanding of scientific and medical research. Particularly, the travel industry has become unquestionably vulnerable amid the COVID-19 outbreak; this pandemic has interrupted the industry's operations with devastating economic consequences. This paper aims to highlight the importance of deconstructing barriers between medical science and public awareness related to COVID-19, taking tourism as a case in point. It also discusses the role of interdisciplinary research in facilitating the tourism and hospitality industry's recovery and alleviating tourists' uncertainties in the wake of …

Problems, Policy And Politics – Perspectives Of Public Health Leaders On Food Insecurity And Human Rights In Australia, Stephanie L. Godrich, Liza Barbour, Rebecca Lindberg

Research outputs 2014 to 2021

Background:

To achieve zero hunger targets set within the United Nations’ Agenda 2030, high-income countries such as Australia must reconsider current efforts to improve food security. This study aimed to; explore perspectives from public health nutrition experts on the usefulness of drawing on the international human right to food, and associated mechanisms, to address food insecurity; identify potential roles of key stakeholders in Australia to implement a rights-based approach; and examine barriers and enablers to achieving the right to food in Australia.

Methods:

Qualitative in-depth interviews were conducted with key informants ( > 10 years professional experience). Braun and Clarke’s (2006) …

Effect Of Occupational Therapy Home Visit Discharge Planning On Participation After Stroke: Protocol For The Home Rehab Trial, Natasha A. Lannin, Lindy Clemson, Avril Drummond, Mandy Stanley, Leonid Churilov, Kate Laver, Sophie O'Keefe, Ian Cameron, Maria Crotty, Tim Usherwood, Nadine E. Andrew, Laura Jolliffe, Dominique A. Cadilhac

Research outputs 2014 to 2021

Introduction: After first stroke, the transition from rehabilitation to home can be confronting and fraught with challenges. Although stroke clinical practice guidelines recommend predischarge occupational therapy home visits to ensure safe discharge and provision of appropriate equipment, there is currently limited evidence to support this recommendation. Methods and analysis: The HOME Rehab trial is a national, multicentre, phase III randomised controlled trial with concealed allocation, blinded assessment and intention-to-treat analysis being conducted in Australia. The trial aim is to determine the effect and potential cost-effectiveness of an enhanced occupational therapy discharge planning intervention that involves pre and postdischarge home visits, …

Vitamin K Intake And Atherosclerotic Cardiovascular Disease In The Danish Diet Cancer And Health Study, Jamie W. Bellenge, Frederik Dalgaard, Kevin Murray, Emma Connolly, Lauren C. Blekkenhorst, Catherine P. Bondonno, Joshua R. Lewis, Marc Sim, Kevin D. Croft, Gunnar Gislason, Christian Torp-Pedersen, Anne Tjønneland, Kim Overvad, Jonathan M. Hodgson, Carl Schultz, Nicola P. Bondonno

Research outputs 2014 to 2021

Background Dietary vitamin K (K1 and K2) may reduce atherosclerotic cardiovascular disease (ASCVD) risk via several mechanisms. However, studies linking vitamin K intake with incident ASCVD are limited. We aimed to determine the relationship between dietary vitamin K intake and ASCVD hospitalizations. Methods and Results In this prospective cohort study, participants from the Danish Diet, Cancer, and Health Study, with no prior ASCVD, completed a food‐frequency questionnaire at baseline and were followed up for hospital admissions of ASCVD; ischemic heart disease, ischemic stroke, or peripheral artery disease. Intakes of vitamin K1 and vitamin K2 were estimated from the food‐frequency questionnaire, …

Vegetable Nitrate Intake, Blood Pressure And Incident Cardiovascular Disease: Danish Diet, Cancer, And Health Study, Catherine P. Bondonno, Frederik Dalgaard, Lauren C. Blekkenhorst, Kevin Murray, Joshua R. Lewis, Kevin D. Croft, Cecilie Kyrø, Christian Torp-Pedersen, Gunnar Gislason, Anne Tjønneland, Kim Overvad, Nicola P. Bondonno, Jonathan M. Hodgson

Research outputs 2014 to 2021

Whether the vascular effects of inorganic nitrate, observed in clinical trials, translate to a reduction in cardiovascular disease (CVD) with habitual dietary nitrate intake in prospective studies warrants investigation. We aimed to determine if vegetable nitrate, the major dietary nitrate source, is associated with lower blood pressure (BP) and lower risk of incident CVD. Among 53,150 participants of the Danish Diet, Cancer, and Health Study, without CVD at baseline, vegetable nitrate intake was assessed using a comprehensive vegetable nitrate database. Hazard ratios (HRs) were calculated using restricted cubic splines based on multivariable-adjusted Cox proportional hazards models. During 23 years of …

Sociodemographic Factors Associated With Childhood Vaccination Status In Sokoto State, Nigeria, Dauda Milgwe Madubu

Walden Dissertations and Doctoral Studies

Immunization remains one of the most successful and cost-effective public health interventions worldwide. Despite the critical role of vaccines in improving childhood and maternal health, Sokoto state recorded the lowest childhood vaccination completion rate among the 37 states in Nigeria with only 5% of children aged 12-23 months having had full childhood vaccination based on data from the 2018 demographic and health survey. The factors associated with the state’s low childhood vaccination status have not been explored. The study examined the relationship between the sociodemographic factors including parents’ socioeconomic and ethnoreligious factors, place of residence, and children’s biological characteristics and …

Impact Of Case Management On Childhood Lead Exposure In Marion County, Indiana, Maliki Yacouba

Walden Dissertations and Doctoral Studies

The Centers for Disease Control and Prevention recently declared that no amount of childhood blood lead level (BLL) is safe. The purpose of this quantitative study with a retrospective cohort design was to evaluate the effectiveness of case management intervention on children diagnosed with elevated BLL (EBLL; ≥ 5 μg/dL) in Marion, County, Indiana. The health belief model was used as the theoretical foundation for the study. A data set of 160 lead exposure case management records was analyzed to find whether: (a) BLL at post-case-management time significantly differ from BLL at baseline (b) BLL at post-case-management time is affected …

Parents’ Decision Making And Uptake Of Human Papillomavirus Vaccination Among Adolescent Males, Franklyn Penn

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) infections account for most oropharyngeal, anal, and penile cancers among men. Two vaccines have been recommended for boys 11 years of age or older to prevent HPV infection, but HPV vaccination rates are far below the Healthy People 2030 target goal. Some research indicates the role of the parent is vital in HPV vaccine uptake, but to what extent is unclear. Through quantitative secondary data analysis of the National Immunization Survey-Teen 2016 (NIS-Teen) data set (n = 43,271) that was grounded in the health belief model, chi-square, and logistic regression analyses revealed three key findings. First, male …

Parents’ Decision Making And Uptake Of Human Papillomavirus Vaccination Among Adolescent Males, Franklyn Penn

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) infections account for most oropharyngeal, anal, and penile cancers among men. Two vaccines have been recommended for boys 11 years of age or older to prevent HPV infection, but HPV vaccination rates are far below the Healthy People 2030 target goal. Some research indicates the role of the parent is vital in HPV vaccine uptake, but to what extent is unclear. Through quantitative secondary data analysis of the National Immunization Survey-Teen 2016 (NIS-Teen) data set (n = 43,271) that was grounded in the health belief model, chi-square, and logistic regression analyses revealed three key findings. First, male …

Reproductive Health Factors And Maternal Mortality Of Internally Displaced Women In Nigeria, Fatima Mahmood Jibirilla

Walden Dissertations and Doctoral Studies

Approximately 529,000 women die from pregnancy-related causes every year, with 99% of these maternal deaths occurring in developing countries. Each year, about 59,000 maternal deaths occur in Nigeria, with a mortality rate of 576 deaths per 100,000 births. Women constitute about half of the 33.2 million internally displaced persons (IDPs) worldwide. The purpose of this retrospective cross-sectional study was to explore the association between the reproductive health factors and maternal mortality of internally displaced women in Borno state, Nigeria. McCarthy and Maine’s model for determinants of maternal mortality informed this study. A secondary dataset of 400 women (age 14-49 years) …

Health Literacy Staff Education For Heart Failure Management, Ifeoma Onyeiwu

Walden Dissertations and Doctoral Studies

Heart failure (HF) is a chronic disease with progressive deterioration that occurs over years or decades. There is a need for individuals affected by HF to be educated regarding this complex disease. Health literacy, an integral part of health and wellness, is one's ability to understand and use health information. Ninety million adults in America have difficulty understanding and using health information, resulting in higher rates of hospitalization and use of emergency services among patients. Limited health literacy may lead to billions of dollars in avoidable healthcare costs. This DNP project addressed health literacy as it relates to medication adherence …

Misuse Of Prescription Pain Relievers Among Pregnant Women In The United States, Winnie Chebet Rono

Walden Dissertations and Doctoral Studies

The non-medical use of prescription pain relievers has increased remarkably, posing social and public health concerns particularly in developed countries such as the United States. The management of pain experienced by pregnant women poses a challenge to clinicians considering the effects of the regimen on unborn babies. Guided by the health belief model, which aims to predict health-related behavior in terms of certain health beliefs and explain change and behavior maintenance as well as to guide health behavior interventions, this cross-sectional study aimed to understand the associations between misusing pain relievers and social determinants of health such as education level …

Effects Of Trained Providers And Naloxone Distribution On Prescription Opioid Use Disorder, Samuel Sarpong

Walden Dissertations and Doctoral Studies

AbstractOpioid abuse and overdose are associated with substantial morbidity and mortality rates, as well as social and economic costs. The purpose of this study was to evaluate the independent and interactive effects of state-sponsored prescription drug monitoring program (PDMP) trained healthcare providers and community-based naloxone distribution program related factors in the states of Florida and Georgia for the prevention and reduction of prescription opioid use disorder, overdose, and deaths. The research theory adopted was the socio-ecological model with an emphasis on risk factors such as age. The study used secondary data from 2014 to 2018 from the Florida and Georgia …

Social Determinants Of Health And Type 2 Diabetes Among Enrollees Of California Children’S Services Program In Fresno County, California, Daniela Marie Aghadjanian

Walden Dissertations and Doctoral Studies

Despite extensive study in adults, Type 2 diabetes (T2D) has been the subject of little research concerning young adults or children. Doctors believed T2D to develop only in a person’s later years until health care providers found younger individuals developing this disease. The purpose of this cross-sectional quantitative analysis was to determine correlations between T2D and social determinants of health in Fresno County, California, based on children and adolescents. The 2017-19 data came from the Fresno County Department of Public Health. The theoretical foundation for the study was the socio-ecological framework focusing on individuals’ traits having a bidirectional impact on …

Breastfeeding Information And Breastfeeding Duration Among African American Women With A Family History Of Breast Or Ovarian Cancer, Aleatha Johnson

Walden Dissertations and Doctoral Studies

Decades of research supports the notion that breastfeeding may help prevent breast and ovarian cancer in women. Women with a family history of these cancers are at greater risk. African American women have the lowest breastfeeding rates, yet the highest breast and ovarian cancer mortality rates. No studies have been conducted exploring the impact of being informed about breastfeeding from health care providers, breastfeeding support services, or family and friends and the relationship between their knowledge of family history of breast or ovarian cancer and breastfeeding duration for African American women. The purpose of this quantitative study was to determine …

Impact Of Out-Of-Pocket Fees On Under-5 Infant Mortality In Cameroon, Amelie Olga Mafotsing Fopoussi

Walden Dissertations and Doctoral Studies

Health facilities in Cameroon charge fees for treatment and services, which can affect health outcomes for those unable to pay for services. Some studies have shown that the removal of user fees had a positive impact on child health outcomes in selected African countries. The aim of this quantitative, cross-sectional study was to understand whether there is a link between out-of-pocket expenses and under-5 mortality in Cameron. The study was guided by the social ecological framework. Secondary data from the 2011 Cameroon Demographic Health Survey were used in the study. Chi-square, binary logistic regression, and multicollinearity analyses were used to …

Access To Preventive Health Care Services And Effects On Health Outcomes For Hispanic Older Adults With Type 2 Diabetes, Shafa Al-Showk

Walden Dissertations and Doctoral Studies

Despite elevated prevalence of diabetes among Hispanic, Hispanic older adults face challenges in self-control and management of their glucose levels, and they have less access to preventive health care services. The purpose of this retrospective quantitative cross-sectional study was to examine the associations between access to preventive health care services and Type 2 diabetes outcomes among Hispanic adults aged 65 years and older. The social-ecological model provided the framework for the study. The research question for this study examined the extent to which doctor visits, diabetes education and blood sugar checks correlate with HbA1c levels. Data were collected from 566 …

Demographic And Socioeconomic Determinants Of Lassa Fever In Edo State, Nigeria, Faith Ogagaroghene Ireye

Walden Dissertations and Doctoral Studies

Lassa fever is a viral hemorrhagic fever caused by the Lassa virus and associated with significant morbidity and mortality. Yearly outbreaks of the disease occur in Edo State, Nigeria. The purpose of this study was to examine the demographic and socioeconomic factors that can influence transmission of the disease. The Commission on Social Determinants of Health conceptual framework was used in this research study. This framework describes the relationship between structural and intermediary factors and how they determine health outcomes. To answer the research question of how demographic and socioeconomic factors influence Lassa fever transmission in Edo State, a cross-sectional …

Diabetes Education For Nursing Staff In Primary Health Care, Artemio Pontejos

Walden Dissertations and Doctoral Studies

The nature of the DNP project was a staff education program for staff nurses and other clinic personnel on diabetes self-care management in a primary health care setting. The goal of this educational program was to improve and update the knowledge on self-care management of primary health care nurses. This education program followed the Walden University DNP Project Manual for Staff Education guidelines. The purpose of this continuing education of professional nurses was to improve nurses’ patient education on self-care management. After a 3-day face-to-face 90-minute lecture, improvement of knowledge was measured with a comparison of a pretest and a …

Fetal/Infant Mortality: Understanding Race And Ethnicity, Birthing Location, And Prenatal Care, Chelsea Collum

Walden Dissertations and Doctoral Studies

This study addressed whether race and ethnicity, birthing location, the month the mother begins prenatal care, and pregnancy risk level impact fetal/infant mortality. Infant mortality is a gauge by which the efficacy of the healthcare system and the overall health of the country is measured. The United States falls behind most other developed countries in terms of infant mortality rates. The ecological perspective was used as the theoretical framework. The study design was a cross-sectional cohort design using a sample of births and infant deaths from U.S. Vital Statistics data. Binomial logistic regression analyses were carried out to calculate odds …

Analysis Of Malaria-Induced Anemia And Gender Differences Among Children In Nigeria, Temitope Bamgbose

Walden Dissertations and Doctoral Studies

Malaria is one of the leading causes of death among children under 5 years old in sub-Saharan Africa (SSA). Also, public health efforts on malaria prevention have been successful in many regions but remains an issue in SSA. Malaria-induced anemia (MA) is associated with health complications among children. The impact of several sociodemographic factors (age, gender, residential type, and parent’s educational level) and malaria preventive/intervention measures such as mosquito net use and malaria medication use among children under 5 years old in Nigeria were assessed to inform malaria best practices and strategies, prioritize resource allocation, and support existing literature on …