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Articles 1 - 19 of 19
Full-Text Articles in Medicine and Health Sciences
Elevated Blood Lead Levels, Cancer Incidence, And All-Cause Mortality In Adults, Sherri L. Davidson
Elevated Blood Lead Levels, Cancer Incidence, And All-Cause Mortality In Adults, Sherri L. Davidson
All ETDs from UAB
Epidemiologic studies have indicated an association between lead exposure and cancer. Although lead exposure has declined in recent decades, from removal of lead in gasoline and paint, lead exposure remains a health concern from environmental and occupational sources including aging water systems. In a retrospective cohort study, Adult Blood Lead Epidemiology and Surveillance (ABLES) records in Alabama were linked to cancer incidence data in the Alabama Statewide Cancer Registry and mortality data from the Alabama Center for Health Statistics, using a probabilistic linkage program. Blood lead level (BLL) measurements were used to categorize exposure levels. Odds ratios approximated relative risks. …
Immunosuppression And Risk Prediction Of Sepsis Following Solid Organ Transplantation, John Patrick Donnelly
Immunosuppression And Risk Prediction Of Sepsis Following Solid Organ Transplantation, John Patrick Donnelly
All ETDs from UAB
Solid organ transplant (SOT) recipients typically need immunosuppressive therapy (IST) to protect graft function and regimens may include an induction agent (e.g., anti-thymocyte globulin [ATG] or alemtuzumab) with maintenance medications (e.g., tacrolimus, mycophenolate mofetil [MMF], mycophenolic acid [MPA], or azathioprine [AZA]). Sepsis, or organ dysfunction resulting from a dysregulated host response to infection, is a common complication among SOT recipients. Using national data from the United States Renal Data System (USRDS), we sought to determine the associations of IST regimens and maintenance medication exposure with sepsis risks and outcomes among kidney transplant recipients (KTRs). Using USRDS and single center data, …
Simulation Of Correlated Variables, Mixture Distributions, And Repeated Measures And Comparison Of Pharmacogenetic Prediction With Machine Learning Methods, Allison Cynthia Fialkowski
Simulation Of Correlated Variables, Mixture Distributions, And Repeated Measures And Comparison Of Pharmacogenetic Prediction With Machine Learning Methods, Allison Cynthia Fialkowski
All ETDs from UAB
Pharmacogenetics aims to improve individualized medicine by combining genetic information with clinical data when assigning drug treatments. Different diseases are often associated with different factors, each with its own distributional characteristics. For rare or complex diseases, these characteristics may not be well understood and standard analysis methods may not be appropriate. In psychiatric disorders, for example, multiple drug treatments need to be compared across small sample sizes with heterogeneous patient populations, making implementation of standard methods difficult. Simulating data that mirrors clinical data is important because it allows investigators to determine which method is best suited for data from their …
Effects Of Medicare Reimbursement Policies On The Quality Of Hospital Care, Monica Aswani
Effects Of Medicare Reimbursement Policies On The Quality Of Hospital Care, Monica Aswani
All ETDs from UAB
This dissertation is composed of two papers related to the role of social risk factors in the Hospital Readmissions Reduction Program (HRRP). As value-based initiatives like the HRRP become more commonplace, there is growing need to understand the relationship between performance in these programs and social risk factors, such as race and poverty, which are not incorporated in the program’s risk adjustment methodology. To address this gap in the literature, this dissertation specifically focuses on three areas: 1) how hospital and community factors are related to average HRRP penalties, taking the context of geography into account, 2) how hospital and …
Immunophenotype In The Molecular Epidemiology Of Breast Cancer, Michael Behring
Immunophenotype In The Molecular Epidemiology Of Breast Cancer, Michael Behring
All ETDs from UAB
This research analyzes the underlying genomic features of breast tumors during immune response, with the overall goal of discovering markers of how tumor immunity and the known features of disease pathology relate. We aimed to 1) identify and validate somatic copy number variation and RNA expression associated with nodal metastasis; 2) construct an array-based measure of tumor infiltrating immune cells and determine its prominent clinical and transcriptional features; and 3) examine the relationship between somatic mutations within p53 and tumor immune cell infiltration status. In two sets of data, gene-level copy number variation (CNV) and RNA expression from the primary …
Heart Failure In A Contemporary Biracial Cohort, Matthew Mefford
Heart Failure In A Contemporary Biracial Cohort, Matthew Mefford
All ETDs from UAB
Heart failure (HF) is the inability of the heart to meet the perfusion needs of the body. HF is a leading contributor to the burden of cardiovascular disease (CVD) and remains a public health concern. Hypertension is a major modifiable risk factor for the prevention and management of HF. Hypertension develops earlier, is less controlled, and has a stronger association with some CVD and renal outcomes among blacks versus whites. These disparities may extend to HF. In addition, adults with HF often have complex treatment regimens due to multimorbidity, making medication adherence an issue. The goal of this dissertation was …
The Evolving Landscape Of Mechanical Circulatory Support In The United States: Observations From National Registries, Ryan Segler Cantor
The Evolving Landscape Of Mechanical Circulatory Support In The United States: Observations From National Registries, Ryan Segler Cantor
All ETDs from UAB
Mechanical circulatory support (MCS) is a rapidly evolving field. This dissertation describes trends in patient selection, device utilization, and outcomes for adult and pediatric patients receiving MCS in the United States by examining data from two national registries. Trends in adult MCS device recipients and their support outcomes were evaluated using data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS), a national registry collecting detailed information for patients implanted with Food and Drug Administration (FDA)-approved durable MCS devices. Between June 2006 and December 2016, INTERMACS enrolled more than 19,000 patients. During this time, the widespread use of devices …
Applying Polytomous Rasch Analysis To Validate Parenting Related Scales, Lei Huang
Applying Polytomous Rasch Analysis To Validate Parenting Related Scales, Lei Huang
All ETDs from UAB
This study applies Rasch analysis to validate two scales in the Parenting for the First-time project: Beck Depression Inventory (BDI-II) and Parenting Stress Index (PSI). The main purpose of this study is to evaluate quality of the two scales by using Rasch analysis to examine the unidimensionality, reliability, fit statistics, group and time invariance, and optimal response categories. Meanwhile, this study also compares the results of Rasch model and Classical Test Theory (CTT) to assess the advantages of Rasch analysis. Result: Both Rach analysis and CTT show the evidence of unidimensionality of BDI-II in the three administrative periods: Prenatal, 6 …
Assessing The Comparative Effect Of Tocilizumab On Risk Of Cardiovascular Disease Among Rheumatoid Arthritis Patients Using Claims Data: A Direct Comparison Among Biologic Disease-Modifying Antirheumatic Drugs, Fenglong Xie
All ETDs from UAB
ASSESSING THE COMPARATIVE EFFECT OF TOCILIZUMAB ON RISK OF CARDIOVASCULAR DISEASE AMONG RHEUMATOID ARTHRITIS PATIENTS USING CLAIMS DATA: A DIRECT COMPARISON AMONG BIOLOGIC DISEASEMODIFYING ANTIRHEUMATIC DRUGS FENGLONG XIE PhD-EPID ABSTRACT Tocilizumab is a humanized monoclonal anti-body against the interleukin-6 receptor and is effective in the treatment of rheumatoid arthritis (RA) [1]. Multiple studies have observed unfavorable changes in the lipid profile of tocilizumab-treated RA patients. Few studies have compared the cardiovascular disease (CVD) risk associated with tocilizumab to other biologic disease-modifying antirheumatic drugs (bDMARDS). Due to limitations in existing studies, the real-world association of tocilizumab with CVD risk remains uncertain. …
Cigarette Smoking Among Hiv-Positive Patients In Routine Clinical Care, Cosmas Mudenda Zyambo
Cigarette Smoking Among Hiv-Positive Patients In Routine Clinical Care, Cosmas Mudenda Zyambo
All ETDs from UAB
People living with HIV (PLWH) are two to three times more likely to be current smokers, less likely to quit smoking and more likely to relapse than those in the general population. Although smoking status, prescription of smoking cessation medications (SCMs), smoking cessation and relapse has been explored in this population, few have investigated using a large sample of PLWH receiving routine HIV care. Using data from a large observational cohort of PLWH receiving routine care in Birmingham, we determined: 1) Factors associated with smoking status; 2) Factors associated with prescription of SCMs; 3) Predictors of smoking cessation and; 4) …
Exploring The Relationship Between Social Support, Pharmacy Access And Medication Adherence, Favel Leah Mondesir
Exploring The Relationship Between Social Support, Pharmacy Access And Medication Adherence, Favel Leah Mondesir
All ETDs from UAB
Barriers of medication adherence exist among people with coronary heart disease (CHD) and CHD risk factors, including, poor social support, poor pharmacy access and other patient, social/economic, therapy, condition, and health-care system/health-care team-related factors. However, there are few data on influence of these factors on medication adherence among people with CHD risk factors other than diabetes. Therefore, this dissertation aimed to investigate associations of medication adherence with social support (n=17,113) and pharmacy access (n=8,250) quantitatively using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study (black and white adults with CHD or CHD risk factors ≥45 …
Social Factors, Public Policies, And Infant Mortality, Lauren Wallace
Social Factors, Public Policies, And Infant Mortality, Lauren Wallace
All ETDs from UAB
Despite consistent and substantial investments, the United States’ infant mortality rate (IMR) has not decreased significantly in the 21st century and disparities between racial and ethnic groups have increased. This study investigates the impact of social and health factors, and public policies on IMR at the state level. The research aims were to: 1) evaluate which state-level social factors and public policies were associated with state IMRs using principal component (PC) analysis; and 2) evaluate whether states cluster on their PC scores and IMRs using cluster analysis. The data used were six composite index scores based on social factor and …
Assessing Barriers And Facilitators To Appropriate Care For Chronic Pain And Prescription Opioid Abuse, Allyson Varley
Assessing Barriers And Facilitators To Appropriate Care For Chronic Pain And Prescription Opioid Abuse, Allyson Varley
All ETDs from UAB
The objective of this study was to understand and assess barriers and facilitators to the uptake of appropriate care for co-occurring chronic noncancer pain (CNCP) and opioid use disorder. Rates of CNCP and opioid overdose have doubled in the past decade. When a patient transitions from appropriate use to misuse, significant changes must be made to their treatment plan. Considering most CNCP is treated with opioids in the primary care setting, primary care providers (PCPs) are potential change agents to remediate the epidemic of opioid abuse. Although studies have explored opioid stewardship, we still lack an understanding of the factors …
Visual, Attentional, And Cognitive Risk Factors For Motor Vehicle Collision Involvement Among Older Adults, Carrie Huisingh
Visual, Attentional, And Cognitive Risk Factors For Motor Vehicle Collision Involvement Among Older Adults, Carrie Huisingh
All ETDs from UAB
Motor vehicle collisions are a major public health problem for older adults in the United States. In 2013, there were 5,671 older adults killed and an estimated 222,000 injured in motor vehicle crashes. After adjusting for miles driven, the risk of crashing increases rapidly after age 70, nearly equal to that of younger drivers whose crash rate is the highest among all age groups. Driving is a highly complex task that relies on a variety of visual and cognitive functions. A large body of work has demonstrated that drivers with visual sensory impairments and/or higher-order visual-cognitive processing deficits, those who …
Psychological Well-Being And Smoking Cessation, Christopher Thorne
Psychological Well-Being And Smoking Cessation, Christopher Thorne
All ETDs from UAB
Introduction: The substantial death toll from smoking combined with the low success rates of current treatment approaches warrants further investigation into mechanisms that promote cessation. While the role of negative affect has been studied extensively in relationship to smoking cessation, the role of psychological well-being (PWB; e.g., life satisfaction, optimism, positive affect, purpose in life, resilience) has received little attention. Treatment outcomes might improve with a better understanding of PWB’s role in smoking cessation. Methods: Relationships between smoking and PWB were examined in three studies. First, using panel data from the biennial, longitudinal Health and Retirement Study, I developed separate …
Hiv Disclosure, Retention In Hiv Care, And Viral Load Suppression : A Study Among New To Hiv Care Patients, Riddhi Modi
Hiv Disclosure, Retention In Hiv Care, And Viral Load Suppression : A Study Among New To Hiv Care Patients, Riddhi Modi
All ETDs from UAB
HIV remains a major ongoing public health problem globally and in the United States (US). Despite the advances in the antiretroviral therapy (ART), new HIV cases continue to occur. Hence, understanding the factors that influence patient’s decision to HIV treatment and prevention is of paramount. HIV disclosure, an important modifiable behavior, is a barrier to linkage and engagement in HIV care. Thus far, studies examining HIV disclosure and its impact on HIV related outcomes, retention in care (RIC) and viral load (VL) suppression among HIV patients newly initiating care are scant. While these studies provide insights on risk factors of …
Assessment Of A Peer Mentoring Program At Lawson State Community College, Teneasha Washington
Assessment Of A Peer Mentoring Program At Lawson State Community College, Teneasha Washington
All ETDs from UAB
ABSTRACT Colleges and universities have begun implementing mentoring programs to offset rising attrition rates; however, the literature on the benefits of these programs is limited particularly among community colleges with peer mentoring programs serving minority students. Further limiting our understanding of post-secondary peer mentoring programs is the lack of research on mentor’s as well as mentee’s perspectives on the mentoring experience. As mentors and mentees serve in a variety of capacities within the mentoring program, it is often difficult to identify outcomes that can be assessed within the mentoring program. Although the success of peer mentoring programs is directly affected …
Psychosocial Job Stress And Oxidative Stress In Emergency Department Nurses, Rupkatha Bardhan
Psychosocial Job Stress And Oxidative Stress In Emergency Department Nurses, Rupkatha Bardhan
All ETDs from UAB
Job stress often causes work-related physical injuries and chronic exposure to such environment may lead to poor health outcomes. Job stress in recent years has grown significantly within the workforce due to performance pressure, long work hours and poor pay structures. Nurses work in the forefront to save patients’ lives. High job demand in this noble profession often leads to progressive decline in physical and mental health. There are existing reports that nurses in the United States (US) suffer from “burnout” syndrome which may also negatively affect patient care. There are very few studies that measured work-related stress in nurses …
Parental Decision-Making In Use Of Complementary And Alternative Medicine, Meka B. Astin
Parental Decision-Making In Use Of Complementary And Alternative Medicine, Meka B. Astin
All ETDs from UAB
One health care trend is the growing public interest in, and use of, complementary and alternative medicine (CAM). Research in the United States suggests that significant numbers of children are involved in various forms of alternative medicine. The purpose of this dissertation is to assess the predictors of parental decision-making of CAM use for their child using five categories of CAM therapies: alternative medical systems, biologically- based, mind-body, manipulative, and a separate and distinct category to include all CAM medical systems. Andersen’s health care Utilization Model (HUM), which holds that health service use is a function of predisposing, enabling, needs …