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Articles 181 - 210 of 417
Full-Text Articles in Public Health
Autism Spectrum Disorders And Social-Ecological Models: Understanding How Context Drives Prevalence, Anne Elizabeth Brisendine
Autism Spectrum Disorders And Social-Ecological Models: Understanding How Context Drives Prevalence, Anne Elizabeth Brisendine
All ETDs from UAB
Background: While there has been significant work done to explore disparities in autism spectrum disorder (ASD) diagnoses with respect to individual characteristics, little work has been done to examine the overall system and structure of the environment in which ASD identification is made and how it is related to diagnosis and services. The purpose of this study is to better understand the social-ecological factors that impact ASD diagnoses at the population level. Methods: In the first aim of this dissertation, a tailored social ecological model was developed and examined across variables in the 2011/12 National Survey of Children’s Health. In …
Racial Disparities In The Maintenance Of Healthy Lifestyles And Their Effect On Cumulative Blood Pressure Burden And Left Ventricular Mass In African Americans And Whites: Data From The Coronary Artery Risk Development In Young Adults (Cardia) Study, John N. Booth
All ETDs from UAB
The prevalence of healthy behaviors associated with optimal blood pressure (BP) levels and reduced risk for target-organ damage and cardiovascular disease (CVD) is lower in blacks compared with whites. Randomized controlled trials provide evidence that if healthy behaviors are maintained over the lifespan, including normal body weight, moderate physical activity, limited alcohol intake, limited sodium intake, adequate potassium intake and a rich diet of fruits and vegetables and low in high-fat dairy and saturated and total fat, then high BP may be preventable. The goal of this dissertation was to assess racial differences in the maintenance of healthy behaviors and …
Effect Of Antihypertensive Drugs On Left Ventricular Traits In Africam American, Anh N. Do
Effect Of Antihypertensive Drugs On Left Ventricular Traits In Africam American, Anh N. Do
All ETDs from UAB
The purpose of this dissertation is to evaluate the association of antihypertensive treatment as well genomic variants with left ventricular (LV) hypertrophy (LVH) -related traits among African Americans (AAs) in five cross-sectional epidemiology cohorts from the United States. AAs especially those with hypertension, are overburdened by left ventricular (LV) hypertrophy (LVH) compared to other ethnic groups. LVH is associated with increased risk for cardiovascular morbidity and mortality. Antihypertensive treatments have been found to improve LVH and related echocardiographic measures (i.e. LV traits) among hypertensive patients. However, the effect of antihypertensive treatments on LVH and related traits in AAs has not …
Phenotypic Characteristics And Dietary Treatment Of Pediatric Non-Alcoholic Fatty Liver Disease, Shima Dowla
Phenotypic Characteristics And Dietary Treatment Of Pediatric Non-Alcoholic Fatty Liver Disease, Shima Dowla
All ETDs from UAB
Background: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder among children in the developed world and can progress to cirrhosis, hepatocellular carcinoma, and liver failure. Objectives: The primary objectives of this dissertation were to (1) review advances in the field of pediatric NAFLD, (2) describe the demographic, anthropometric and metabolic characteristics of children with NAFLD and evaluate whether differences existed based on ethnicity and diagnostic method, and (3) compare the effect of a carbohydrate restricted diet vs fat reduced diet on improvement in hepatic steatosis over an 8-week period among overweight and obese children diagnosed with NAFLD. …
Statistical Tests For Confounding, Falynn Cartmill Turley
Statistical Tests For Confounding, Falynn Cartmill Turley
All ETDs from UAB
The use of propensity score methods have increased tremendously in the last several years. Propensity scores are used as a tool to correct the effects of confounding that can result in biased estimates of treatment effects. However, there is more than one method that employs propensity scores, and there is no guide in choosing the optimal method, in terms of Type I error and statistical power. This research aims to assess these attributes through a complex simulation study of a five variable model. The results of the simulations indicate performance of a particular propensity score method is dependent
Comparative Analysis Of New Techniques For Hearing Conservation Program Selection, Laura Hurst
Comparative Analysis Of New Techniques For Hearing Conservation Program Selection, Laura Hurst
All ETDs from UAB
Hazardous noise is a widespread problem in industry and recreation. Noise induced hearing loss is one of the most frequently reported occupational health claims worldwide. While there has been much research on noise, its effects, and how to prevent hearing loss in industry, there is limited research available to help quantify the difference that monitoring noise at a lower threshold might create in the measured exposure estimate. Additionally, the studies involving the use of different noise monitoring settings do not attempt to explain how the results might change the outcomes when using data and statistical techniques to classify similar exposure …
Alternative Methodological Approaches For Quantifying Dental Caries And Non-Water Beverage Consumptions For The Improvement Of Caries Risk Analyses In Children, Kelsey Harris Jordan
Alternative Methodological Approaches For Quantifying Dental Caries And Non-Water Beverage Consumptions For The Improvement Of Caries Risk Analyses In Children, Kelsey Harris Jordan
All ETDs from UAB
Researchers assume caries progress constantly, all crowned/extracted tooth surfaces are carious, and non-water beverage consumption (NWBC) habits are similar by relying on increments, dmfs scoring, and consumption frequencies, respectively. These assumptions are likely inaccurate. The purpose of this research was to evaluate and modify the use of 1) longitudinal caries disease assessment, 2) the dmfs score and 3) NWBC variables to more accurately estimate disease and identify risk factors. To investigate, young (8-18 months at baseline), healthy, poor, rural, African American, Alabamian children were observed annually for five years. Three calibrated dentists performed oral examinations (without radiographs), calculating the number …
Sample Size Re-Estimation For Confirmatory Two-Stage Multi-Arm Trials With Normal And Binary Outcomes, Yan Li
All ETDs from UAB
Multi-arm clinical trials comparing several treatments against a common control are more efficient than traditional multiple two-arm trials. Several flexible multi-arm designs which utilize the closed test procedure for strong familywise error rate control have been proposed to allow treatment selection and sample size re-estimation (SSR) at the interim analysis. Because of the interdependence among hypothesis tests for each treatment induced by the closed test procedure, SSR methods for two-arm trials are not directly applicable to multi-arm trials. Further, there is limited literature on methods for SSR in multi-arm trials. In paper 1, we derive SSR procedures based on the …
A Statistical Approach To Computed Tomography Perfusion, Seth Thomas Lirette
A Statistical Approach To Computed Tomography Perfusion, Seth Thomas Lirette
All ETDs from UAB
Stroke is, and will continue to be, a pervasive problem in the both the United States and across the world, and computed tomography (CT) perfusion scanning will continue to be a first-line diagnostic tool to quantify where and how much blood flow occlusion is present in the brain. CT perfusion maps displaying several scalar perfusion parameters for each brain voxel will continue to be used by radiologists and other clinicians. The goal of this dissertation is to examine and improve upon current standards of practice concerning CT perfusion. We first exhibit how software that constructs perfusion maps can be implemented …
Univariate Frailty Model For Competing Risks Data Analysis, Yuliang Liu
Univariate Frailty Model For Competing Risks Data Analysis, Yuliang Liu
All ETDs from UAB
Unobserved individual heterogeneity, that is frailty, is a major concern in the application of analysis for competing risks data. Unlike the study of clustered competing risks data using multivariate frailty models, we have not found a study of non-clustered competing risks data using univariate frailty model. This dissertation focuses on developing frailty models for the analysis of non-clustered competing risks data. The estimation of the effects of covariates by a parametric univariate frailty model could be a useful approach when heterogeneity must be considered in the non-clustered competing risks setting. In paper 1, we compared the performance of the Cox, …
Formaldehyde Emissions From Laminate Flooring, Stephanie Latisha Marzette
Formaldehyde Emissions From Laminate Flooring, Stephanie Latisha Marzette
All ETDs from UAB
In recent years, several incidents have caused public concern about the levels of formaldehyde present in residential homes. It is one of the most prevalent and regularly detected pollutants in an indoor environment. This is due to the presence of formalde-hyde in many common products, such as household cleaners and paints, as well as build-ing materials. Formaldehyde exposure can lead to sore throat, coughing, eye and airway irritation, and increased occurrences of asthma symptoms. Due to the public health con-cerns, this research was designed to investigate the distinctive nature of formaldehyde emissions from laminate flooring and test the reliability of …
The Association Between Cancer And Risk Of Sepsis Among Whites And Blacks In The Regards Cohort, Justin Xavier Moore
The Association Between Cancer And Risk Of Sepsis Among Whites And Blacks In The Regards Cohort, Justin Xavier Moore
All ETDs from UAB
Cancer is the second leading cause of morbidity and death in the United States corresponding to more than 1.7 million incident cases and responsible for more than 550,000 deaths annually. In addition, hospitalized cancer patients are nearly 10 times more likely to develop sepsis when compared to participants with no cancer history. As treatments and therapies for cancer continue to improve, the average 5-year survival is approaching 70% overall among the US population; however, to date there is very limited research that has examined the association between patients with a history of cancer and future risk of sepsis among a …
Effective Recruiting For Subgroups In The Systolic Blood Pressure Intervention Trial (Sprint), Thomas Marshall Ramsey
Effective Recruiting For Subgroups In The Systolic Blood Pressure Intervention Trial (Sprint), Thomas Marshall Ramsey
All ETDs from UAB
EFFECTIVE RECRUITING FOR SUBGROUPS IN THE SYSTOLIC BLOOD PRESSURE INTERVENTION TRIAL (SPRINT) THOMAS MARSHALL RAMSEY HEALTH EDUCATION / HEALTH PROMOTION ABSTRACT Background: The Systolic Blood Pressure Intervention Trial (SPRINT) recruitment focused on participants > 50 years old with systolic blood pressure of > 140 mm Hg (hypertension) with no evidence of diabetes or previous stroke. Priority participants were targeted in non-clinical subgroups (women and minorities) as well as three clinical subgroups (pre-existing cardiovascular disease, pre-existing chronic kidney disease, > 75 years old). Objective: The objective of this secondary analysis is to determine which of the five recruiting strategies was most effective? Which recruitment …
Modeling Depression Treatment Strategies For Human Immunodeficiency Virus (Hiv) Positive Patients, Rongbing Xie
Modeling Depression Treatment Strategies For Human Immunodeficiency Virus (Hiv) Positive Patients, Rongbing Xie
All ETDs from UAB
This dissertation empirically examines the associations between depression and HIV-related outcomes, simulates both care and outcomes under different depression care strategies, and compares the cost effectiveness of various depression care strategies to the current care strategy. The empirical investigations reveal the negative associations between depression and HIV-related outcomes using two longitudinal patient-level databases. Furthermore, the patterns and outcomes of depression care are identified and simulated using agent-based modeling. Finally, simulated costs and effectiveness are used to evaluate different depression care strategies for reducing new HIV infections and improving quality of life. The current standard of care for depression among patients …
Statistical Methods In Cancer Survival Prediction And Microbiome Data Analysis, Xinyan Zhang
Statistical Methods In Cancer Survival Prediction And Microbiome Data Analysis, Xinyan Zhang
All ETDs from UAB
This dissertation focused on developing statistical methods in two areas, cancer survival prediction and microbiome data analysis. Heterogeneity in terms of tumor characteristics, prognosis, and survival has been a persistent problem in cancer prediction and prognosis for many decades. One of the main shortcomings of past studies is the failure to incorporate prior biological information into the predictive model, given strong evidence of pathway-based genetic nature of cancer. In paper 1, to address this problem, we propose a two-stage approach to incorporate pathway information into the prognostic modeling using large-scale gene expression data. In the first stage, we fit all …
Comparative Performance And Clinical Utility Of Indirect Treatment Comparison Estimators, William Hillegass
Comparative Performance And Clinical Utility Of Indirect Treatment Comparison Estimators, William Hillegass
All ETDs from UAB
In the clinical decision between two or more discrete competing diagnostic or therapeutic patient care strategies, the main consideration is typically the expected difference in the primary outcome of interest. When head-to-head randomized trial results are unavailable or insufficient, this expected difference in outcome can be estimated with an indirect comparison in some settings. Publication of formalized indirect comparisons and proposed statistical methods in the medical literature began in 1993. Despite growing acceptance of indirect treatment comparisons as credible evidence, the statistical underpinnings, properties, and performance of these methods both individually and comparatively remain incompletely explored and defined. This dissertation …
Implementation Of Repeat Hiv Testing During Pregnancy In Kenya, Anna Joy Graves Rogers
Implementation Of Repeat Hiv Testing During Pregnancy In Kenya, Anna Joy Graves Rogers
All ETDs from UAB
It is estimated that a third of all mother-to-child transmission (MTCT) of HIV occurs in women with incident HIV infection during pregnancy, potentially contributing to over 37,000 pediatric HIV infections globally and 4,300 infections in Kenya on an annual basis. Since most pregnant women with acute HIV infection test negative for HIV during routine early-pregnancy antenatal testing, they may not receive access to life-saving antiretroviral therapy (ART) for their own sake, as well as to prevent perinatal HIV transmission. A comprehensive strategy to eliminate MTCT will require identifying and addressing incident HIV infection. International recommendations suggest that pregnant women in …
Admixture Mapping Of Subclinical And Clinical Cardiovascular Disease Among African Americans, Aditi Shendre
Admixture Mapping Of Subclinical And Clinical Cardiovascular Disease Among African Americans, Aditi Shendre
All ETDs from UAB
The purpose of this dissertation is to evaluate the association of local European ancestry (LEA) with subclinical and clinical cardiovascular (CV) disease (CVD) among African Americans in three prospective cohorts from the United States. CVD burden is higher among African Americans compared to other racial/ethnic groups and prevention efforts have led to the evaluation of subclinical measures of CVD such as carotid artery intima-media thickness (CIMT), and risk factors including the underlying genetic component of the disease. Admixed populations such as African Americans may have increased risk of disease as a result of the increased prevalence of a disease among …
Methods For Analysis Of Genetic Differences In Sex And Ethnicity For Complex Human Traits, Yogasudha Veturi Veturi
Methods For Analysis Of Genetic Differences In Sex And Ethnicity For Complex Human Traits, Yogasudha Veturi Veturi
All ETDs from UAB
In the last two decades, thousands of genome-wide association (GWA) analyses have been published. These studies have been primarily conducted using data from Caucasians and many of the reported findings have not been replicated in other populations, perhaps reflecting that the underlying architecture of effects may vary across ethnically diverse groups. Similarly, the possibility that the genetic architecture of traits may vary between males and females has also been overlooked. We propose a methodology for estimation and testing of effect heterogeneity between groups such as sex or ethnicity that involves modeling genotype-by-group random interactions. Using simulations, we show that the …
Cardiovascular Risk Factors In Ambulatory Blood Pressure Monitoring Phenotypes, Samantha G. Bromfield
Cardiovascular Risk Factors In Ambulatory Blood Pressure Monitoring Phenotypes, Samantha G. Bromfield
All ETDs from UAB
Hypertension and diabetes are common and are known risk factors for cardiovascular disease (CVD). Several blood pressure (BP) phenotypes, identified by ambulatory BP monitoring (ABPM), have been reported to be associated with an increased risk for CVD. However, there are few data on ABPM phenotypes among individuals with diabetes. Identifying modifiable factors that improve cardiovascular health may reduce CVD events and the prevalence of ABPM phenotypes, such as masked hypertension. Given the ability of ABPM to identify unconventional BP phenotypes that provide prognostic information beyond clinic BP, it is important to understand the optimal number of 24-hour ABPM readings necessary …
Use Of Medicare Inpatient Claims Data For The Identification Of Myocardial Infarction, Lisandro Damian Colantonio
Use Of Medicare Inpatient Claims Data For The Identification Of Myocardial Infarction, Lisandro Damian Colantonio
All ETDs from UAB
Claims are being used for the identification of myocardial infarctions (MI) in research studies, either as a complement of primary data collection or as the sole data source. However, few data are available to support these approaches. The current dissertation analyzes the use of claims for the identification of MIs in a large population-based cohort linked to Medicare data, the REasons for Geographic and Racial Differences in Stroke study. Analyses included 9,951 study participants ≥65 years of age with Medicare Part A (inpatient) fee-for-service coverage at baseline in 2003-2007. Participant self-report and Medicare inpatient claims with a diagnosis code for …
Methods For Measuring Individually Experienced Temperature And Food Intake In Controlled Thermal Environments, Molly Bernhard
Methods For Measuring Individually Experienced Temperature And Food Intake In Controlled Thermal Environments, Molly Bernhard
All ETDs from UAB
The three studies to be presented assess individual-level heat exposure in free-living urban and rural environments and assess food intake in randomized controlled trials in a 2-hour exposure, and a 7-hour crossover heat exposure. The first interest was broad: examining heat exposure and its relation to potential health outcomes. To examine whether heat exposure could be measured in free-living organisms, a light and temperature monitoring device was repurposed and used in a pilot study of individual-level heat exposure in urban and rural community members. Differences between the current and most commonly accepted way of estimating heat exposure, weather station datasets, …
Performance Of Ordinary Least Squares And Heteroskedasticity Consistent Covariance Matrix Estimators In Heteroskedastic Analysis Of Covariance Models, Erica Lynn Dawson
Performance Of Ordinary Least Squares And Heteroskedasticity Consistent Covariance Matrix Estimators In Heteroskedastic Analysis Of Covariance Models, Erica Lynn Dawson
All ETDs from UAB
Ordinary Least Squares Optimization is one of the most widely used methods in statistical analysis to estimate the parameters of a general linear model. Yet, when the assumption of homoskedastic errors is violated, the statistical model is incorrectly specified and alteration of both Type I and Type II error rates occurs. We examine different heteroskedasticity consistent covariance matrix estimators (HCCM) under various heteroskedastic analysis of covariance (ANCOVA) models with orthogonal predictors, and find that under the test of group differences, MacKinnon and White’s HC2 and Davidson and MacKinnon’s HC3 perform reasonably well in terms of Type I error control; and …
Measuring Reproductive Norms And Stigma And Examining Their Roles In Unintended Pregnancy-Related Health Behavior Among Young Adult Women, Whitney Smith
All ETDs from UAB
Substantial disparities are observed in rates of unintended pregnancy and the health consequences of unintended pregnancy in the United States, with these events and outcomes occurring more frequently among young adult women and women in the southern region. The contribution of social norms and stigma to these disparities is unclear. This dissertation is comprised of three manuscripts examining unintended pregnancy-related norms and stigma, and their health implications among young adult women aged 18-24 in Birmingham, Alabama. The aims of the dissertation are to (1) elucidate perceptions of norms and stigma regarding unintended pregnancy and pregnancy decisions (abortion, adoption, and parenting), …
Malaria, Changes In Angiogenesis Factors, Cytokine Profiles And Birth Outcomes, John A. Keenan
Malaria, Changes In Angiogenesis Factors, Cytokine Profiles And Birth Outcomes, John A. Keenan
All ETDs from UAB
Malaria remains an important public health problem, with over three billion people at risk of infection and as many as 214 million new cases each year. Of particular concern is the effect Plasmodium falciparum malaria has on reproductive health. Malaria is responsible for a wide array of adverse birth outcomes including infant death, low birth weight, preterm delivery and small for gestational age. The mechanism by which malaria influences adverse birth outcomes remains poorly understood. Cross-sectional data from 291 women delivering infants in Ghana are used to investigate whether malaria during pregnancy was associated with select cytokines or angiogenesis factors …
Fabrication And Characterization Of Buckypapers For Use In Air Sampling, Jonghwa Oh
Fabrication And Characterization Of Buckypapers For Use In Air Sampling, Jonghwa Oh
All ETDs from UAB
FABRICATION AND CHARACTERIZATION OF BUCKYPAPERS FOR USE IN AIR SAMPLING JONGHWA OH ENVIRONMENTAL HEALTH SCIENCES ABSTRACT Occupational exposure to volatile organic compounds (VOCs) is a concern from a public health perspective. In many industrial activities, workers’ exposure to VOCs can be sufficiently high to induce adverse health effects, so their monitoring is necessary. In exposure assessment, post sampling extraction and quantification are the typical analytical procedures. Recently, our group developed the photothermal desorption (PTD) technique in which a pulse of light thermally desorbs an analyte directly from a sorbent. Advantages of this technique are; it is solvent free, repeated analysis …
Influence Of Maternal Age On The Effects Of Organic Selenium In The Animal Model Daphnia Pulex, Jordan E. Roberts
Influence Of Maternal Age On The Effects Of Organic Selenium In The Animal Model Daphnia Pulex, Jordan E. Roberts
All ETDs from UAB
As a necessary micronutrient, seleno-L-methionine (SeMet) exhibits a U-shaped dose-response with deficiency and toxicity leading to adverse health outcomes. Some studies suggest dietary selenium may offer protection against toxicity from other metals, but excessive dietary levels can also lead to toxicity. In addition, increased maternal age has been shown to increase the risk of adverse developmental outcomes. We hypothesize that older maternal age will increase susceptibility in offspring exposed to toxic concentrations of SeMet. The goal of this project was to evaluate the effects of SeMet treatment on lifespan and determine if the effects are altered by maternal age using …
The Use Of An Open-Label Placebo To Treat Cancer-Related Fatigue In Cancer Survivors, Theresa Walker Hoenemeyer
The Use Of An Open-Label Placebo To Treat Cancer-Related Fatigue In Cancer Survivors, Theresa Walker Hoenemeyer
All ETDs from UAB
Background: A placebo is an inert substance (e.g., sugar pill) or procedure (e.g., sham surgery) that should confer no beneficial effects. Nonetheless, typically, 30-50% of those randomized to placebos report significant benefits. New studies indicate that the use of disclosed or open-label placebos reduces self-reported symptoms among patients with irritable bowel syndrome, migraine attacks, and major depression. Methods: The investigator conducted a 7-week pilot study to evaluate the feasibility and effects of an open-labeled administration of placebo pills on patient-reported clinical and psychosocial outcomes among cancer survivors seeking relief from cancer-related fatigue. The specific aims of this study were to: …
Impact Of And Adoption Trends Of Hit In Cancer Care, Willi L. Tarver
Impact Of And Adoption Trends Of Hit In Cancer Care, Willi L. Tarver
All ETDs from UAB
The three discrete research projects which make up this dissertation provide empirical evidence on the impact of, and adoption trends of, health information technology (HIT) as it pertains to cancer care. The findings of these studies are important as they provide insight into the potential of HIT to improve the quality of cancer care in the US. The results of this dissertation suggest that based on the current literature, HIT interventions seem to be more successful when targeting physicians, care in the prevention phase of the cancer continuum, and/or decision making. Separately, when seeking to understand the adoption of electronic …
Individual, Family, And Social Factors Associated With Adolescent Obesity: A Policy Relevant Focus, Janice Marguerite Utley
Individual, Family, And Social Factors Associated With Adolescent Obesity: A Policy Relevant Focus, Janice Marguerite Utley
All ETDs from UAB
INDIVIDUAL, FAMILY, AND SOCIAL FACTORS ASSOCIATED WITH ADOLESCENT OBESITY: A POLICY RELEVANT FOCUS JANICE M. UTLEY PUBLIC HEALTH ABSTRACT This dissertation is comprised of three papers that examined individual, family, and social factors associated with adolescent overweight and obesity with the aim of generating data that could inform the design of policy interventions to prevent or reverse rising prevalence. The first investigation was a type of literature review called a scoping study that examined the extent, range, and type of research activity on adolescent obesity that used a multilevel or hierarchical design to look at two or more contextual areas …