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Access To Care, Structural Barriers, And Recovery Identity In Mental Health And Substance Use Disorder Treatment, Yahya Alnashri Sep 2025

Access To Care, Structural Barriers, And Recovery Identity In Mental Health And Substance Use Disorder Treatment, Yahya Alnashri

All ETDs from UAB

Substance use disorders (SUDs) remain one of the most pressing public health and economic challenges in the United States, with growing recognition that recovery is a multidimensional process shaped by clinical, social, and structural factors. This dissertation explores recovery at the levels of health policy, population, and experiential levels to assess gaps in access to recovery support services, identify patterns and predictors of recovery identity, and highlight the lived experiences of individuals with opioid use disorder. First, we evaluated whether state Medicaid expansion under the ACA (2010–2019) was associated with changes in the availability of consumer-run peer support services in …


Turn On, Tune In, Drop Shame: Exploring The Unique Therapeutic Potential Of Psychedelics For Sexual And Gender Minority Populations, Nicholas Carlisle Sep 2025

Turn On, Tune In, Drop Shame: Exploring The Unique Therapeutic Potential Of Psychedelics For Sexual And Gender Minority Populations, Nicholas Carlisle

All ETDs from UAB

Sexual and gender minority (SGM) individuals face significant disparities in mental and physical health compared to their heterosexual and cisgender counterparts, due in part to chronic exposure to distal and proximal minority stressors. Shame – a self-focused characterized by a global sense of personal deficiency or unworthiness – has emerged as a key intrapersonal mechanism linking minority stressors to adverse health outcomes. This dissertation explores the role of shame in SGM health inequities and investigates the emerging potential of psychedelics to reduce shame and improve health and wellbeing in these populations. This three-paper dissertation begins with a scoping review (Paper …


Exploring The Lived Experiences Of Persons Living With Hiv Who Are Homebound Due To One Or More Comorbidities Within A Southern State Using Photovoice, Anthony Alyn "Deek" Cunningham Jan 2025

Exploring The Lived Experiences Of Persons Living With Hiv Who Are Homebound Due To One Or More Comorbidities Within A Southern State Using Photovoice, Anthony Alyn "Deek" Cunningham

All ETDs from UAB

At the end of 2022, there were 1,109,418 adults and adolescents with HIV in the United States and the six dependent areas of American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the Republic of Palau, and the US Virgin Islands (CDC, 2024). Due to ongoing advances in medications and treatments, people who have been diagnosed with HIV are living longer and healthier lives, making this a chronic health condition. Yet, there are gaps in the literature that focuses on this population growing older and aging in place. This dissertation investigated the lived experiences of individuals fifty years and older …


Predictors Of Antidepressant Use In Stroke Survivors And Evaluating The Role Of Time-Varying Depressive Symptoms On The Association Between Antidepressant Use And Stroke, Hely Divyanshu Nanavati Jan 2025

Predictors Of Antidepressant Use In Stroke Survivors And Evaluating The Role Of Time-Varying Depressive Symptoms On The Association Between Antidepressant Use And Stroke, Hely Divyanshu Nanavati

All ETDs from UAB

Depression is a mental health crisis affecting 21 million Americans. Consequently, antidepressants are one of the most prescribed classes of medications in the American population. Depression is also a common adverse outcome after stroke with one in three patients having depressive symptoms within the first year of their stroke recovery phase. Antidepressants are effective in the treatment and prevention of depressive symptoms in stroke patients. However, the overall antidepressant use in the acute post-stroke phase and the patient characteristics influencing the prevalence of receiving antidepressant prescriptions during acute stroke hospitalization are not known. Depression is also associated with higher risk …


Parental Monitoring, Peer Connectedness, And Potential Exposure To Stis In Adolescents Using The Youth And Risk Behavior Survey (Yrbs) Of 2021, Allyson L. Pullen Jan 2025

Parental Monitoring, Peer Connectedness, And Potential Exposure To Stis In Adolescents Using The Youth And Risk Behavior Survey (Yrbs) Of 2021, Allyson L. Pullen

All ETDs from UAB

Background: Adolescents are significantly affected by sexually transmitted infections (STIs), a public health challenge linked to high-risk sexual behaviors, including early sexual initiation, unprotected intercourse, multiple partners, and substance use. Protective factors such as parental monitoring and peer connectedness have demonstrated the potential to reduce adolescent risky behaviors. This study aims to examine the relationship between parental monitoring, peer connectedness, and potential exposure to STIs in high school students. Methods: This study analyzed data from the 2021 Youth Risk Behavior Survey (YRBS), focusing on potential STI exposure, parental monitoring, and peer connectedness among U.S. high school students. Potential STI exposure …


Gateways, Barriers, And Facilitators To Opioid Use Treatment For Low-Income Pregnant And Postpartum Women In The State Of Alabama, Lindsey Allison Rice Bender Jan 2025

Gateways, Barriers, And Facilitators To Opioid Use Treatment For Low-Income Pregnant And Postpartum Women In The State Of Alabama, Lindsey Allison Rice Bender

All ETDs from UAB

Low income, pregnant and postpartum women who misuse opioids in the state of Alabama face potentially life-threatening challenges when seeking substance misuse treatment and recovery support services. Our study used an explanatory sequential mixed-methods approach to explore gateways, barriers, and facilitators to opioid use disorder (OUD) treatment for pregnant and postpartum women in the state of Alabama. Surveys from 32 pregnant and postpartum individuals and in-depth interviews with 15 pregnant and postpartum individuals (four pregnant, four 0-6 months postpartum, four 7-12 months postpartum and three 13-18 months postpartum) were used to identify gateways, barriers, and facilitators to OUD treatment. Our …


The Relationship Between Molten Iron Chemistry Of A Cupola Furnace And Airborne Contaminants, Darkeya D. Rowe Jan 2025

The Relationship Between Molten Iron Chemistry Of A Cupola Furnace And Airborne Contaminants, Darkeya D. Rowe

All ETDs from UAB

The purpose of this research was to understand the potential relationship between the molten iron chemistry of a cupola furnace and airborne contaminants. Three-day air sampling was performed for the emissions of a cupola furnace using 37 mm mixed cellulose ester (MCE) filter cassettes at an iron foundry. The samples were analyzed for 21 elements and compounds by a commercial laboratory using the modified National Institude for Occupational Safety and Health (NIOSH) Method 7303, most of which were metals. The concentrations of 13 out of 21 elements and compounds were compared to the corresponding elements in molten metal/iron stream analyzed …


Co-Creating A Social, Emotional, And Mental Health Well-Being Group For College Students With Disabilities And/Or Chronic Health Conditions And Are Registered With Disability Support Services, Consuelo A. Click Copeland Jan 2025

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

All ETDs from UAB

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


Effect Of Pre-Treatment Lab-Based Comorbidities On Treatment Related Outcomes Among Patients With Cancer, Jeffrey Alan Franks Jan 2025

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

All ETDs from UAB

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


Occupational Exposure To Cooking Emissions And Evaluation Of Ventilation System In Restaurant Kitchens, Matthew Kaleb Hanvey Jan 2025

Occupational Exposure To Cooking Emissions And Evaluation Of Ventilation System In Restaurant Kitchens, Matthew Kaleb Hanvey

All ETDs from UAB

Background: In the restaurant environment, there are many harmful contaminants generated during the cooking process that kitchen workers are potentially exposed to. The purposes of this study were to evaluate the potential exposure to aldehydes and respirable particles among restaurant kitchen workers and to examine the ventilation performance of the kitchen exhaust hoods. Methods: There were three restaurants recruited for this study and they cooked seafood/poultry (Restaurant 1), farm style foods (Restaurant 2), and finger foods (Restaurant 3). The three restaurants had wall-mounted canopy hoods. Restaurant 1 had two hoods, Restaurant 2 had two hoods, and Restaurant 3 had one …


The Impact Of Transportation Insecurity On No-Show Appointments And Acute Care Utilization In Pediatric Sickle Cell Patients, Seabrook Hannah Jeffcoat Jan 2025

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

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


"The Association Between Serious Psychological Distress And Life Satisfaction Among U.S Adults With Hypertension", Kellen Michael Lenz Jan 2025

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

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


Exploring The Impact Of Returning To Office Work Post-Pandemic On The Mental Health Of Workers: A Cross-Sectional Analysis, Jasmine M. Nelson Jan 2025

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

All ETDs from UAB

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


Examining Daily-Self Weighing As A Stand-Alone Intervention For Obesity Management, Ashley Parish Sep 2024

Examining Daily-Self Weighing As A Stand-Alone Intervention For Obesity Management, Ashley Parish

All ETDs from UAB

Obesity is an epidemic that has substantial implications for both individuals with the disease as well as the healthcare system in the United States. Individuals with obesity are at increased risk for developing associated co-morbid conditions such as cardiovascular disease, type 2 diabetes, and some forms of cancer, which can affect quality of life and lead to mortality. There are many health behavior interventions which target weight loss, maintenance of weight loss, or weight gain prevention in those with obesity; however, interventions have unique barriers that can vary based on personal, environmental, and social factors. Primary care (PC) settings, which …


Factors Associated With Early Onset Anal Cancer And Facilitators And Barriers To Screening Among Men Living With Hiv And Their Providers In The Deep South: A Mixed Methods Investigation, Anna Junkins Sep 2024

Factors Associated With Early Onset Anal Cancer And Facilitators And Barriers To Screening Among Men Living With Hiv And Their Providers In The Deep South: A Mixed Methods Investigation, Anna Junkins

All ETDs from UAB

For my dissertation work, I aimed to 1) determine the occurrence of early onset (diagnosis at <50 years) anal cancer and the impact of HIV infection and other risk factors, and 2) utilize a mixed methods research approach to identify and explain factors associated with screening among men living with HIV (MLHIV) and their providers. In Aim 1, I used logistic regression to estimate the odds of early onset cancer by sociodemographic and clinical characteristics among anal cancer patients in the Alabama cancer registry from 2012-2018. Among 519 patients, 17.7% were diagnosed at <50 years. Male sex, Black race, and HIV infection were associated with younger age at diagnosis. Black patients had a 4-fold increased odds of early onset anal cancer compared to White patients and disproportionately lived in areas with higher social vulnerability. In Aim 2, I used logistic regression to estimate the odds of anal cancer screening by sociodemographic and sexual risk characteristics among MLHIV using retrospective survey data from 1917 Clinic in 2018. Among 1,114 men, 52% had received an anal pap within one year of completing the survey. Men who were screened were more likely to have multiple sexual partners. Heterosexual men had lower odds and men who reported unprotected anal sex had higher odds of screening. Older Black men were less likely to be screened. In Aim 3, I used thematic analyses to identify themes related to health beliefs, barriers and facilitators, and perceived and evaluated need of screening using in-depth interviews among MLHIV and their providers. Benefits of screening among MLHIV were early detection and awareness about one’s body. Suggestions for overcoming barriers to screening among providers included screening guidelines, patient education, inclusion of screening into routine care, and self-collection. Among men that were aware of HPV-associated cancers, there was perceived risk and desire to receive HPV vaccination. Individuals who are male, Black, or living with HIV may be at increased risk of developing anal cancer younger. Among MLHIV, improving education about HPV-associated cancer, and offering self-collected screening as part of routine care could facilitate screening in the South.


The Association Between Social Connectedness And Opioid Reuse Among Vulnerable Groups Receiving Medication For Opioid Use Disorder, Jolanda Lynn Hudson Sep 2024

The Association Between Social Connectedness And Opioid Reuse Among Vulnerable Groups Receiving Medication For Opioid Use Disorder, Jolanda Lynn Hudson

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THE ASSOCIATION BETWEEN SOCIAL CONNECTEDNESS AND OPIOID REUSE AMONG VULNERABLE GROUPS RECEIVING MEDICATION FOR OPIOID USE DISORDER JOLANDA L. HUDSON PUBLIC HEALTH ABSTRACT Introduction: Opioid Use Disorder (OUD) is a serious illness that continues to persist despite the many efforts of researchers, physicians, government agencies, state, and local programs, to eliminate the mortality rate associated with this disease. Although manageable, OUD is still taking the lives of citizens due to illegal opioid misuse. Understanding the dynamics of the disease and the contributing factors in various populations may inform researchers in successful intervention outcomes. Methods: A retrospective secondary data analysis utilizing …


Changes In Drug And Alcohol Behaviors Before And After An Educational Intervention Among At-Risk Adults And Youth, Isabel Cuellar Acker Sep 2024

Changes In Drug And Alcohol Behaviors Before And After An Educational Intervention Among At-Risk Adults And Youth, Isabel Cuellar Acker

All ETDs from UAB

Introduction: Substance abuse is defined as the excessive use of a drug in a way that is detrimental to oneself, society, or both. Gender is important to examine because it is becoming more common for females to develop substance use disorders and for their substance use to be more severe. This study will address the role of an education-based intervention on substance abuse in an area that is at the intersection of rural and urban geography with a unique pool of participants. Methods: This is a longitudinal cohort study that has a pre-post intervention design. A linear model was used …


Prevention Of Spina Bifida Through Fortification Of Iodized Salt With Folic Acid, Anastasia Arynchyna Smith Sep 2024

Prevention Of Spina Bifida Through Fortification Of Iodized Salt With Folic Acid, Anastasia Arynchyna Smith

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The overarching goal of the three-paper dissertation is to address the gaps in the literature on the clinical care burden of preventable spina bifida on the global neurosurgical community and the need for a universal food vehicle for fortification with folic acid as a novel prevention strategy. It is known that sufficient intake of folic acid is imperative to prevent neural tube defects (spina bifida) in the developing fetus in the first month post-conception. It is also known that fortifying staple foods is the most cost-saving and effective prevention method. However, very few countries have mandatory fortification policies. Therefore, the …


It's A Man's World: The Association Between Safe Sex Practices, Relationship Power, & Resilience Among African American Emerging Adults Between 18-24 In The Deep South, Jessica Morgan Sep 2024

It's A Man's World: The Association Between Safe Sex Practices, Relationship Power, & Resilience Among African American Emerging Adults Between 18-24 In The Deep South, Jessica Morgan

All ETDs from UAB

The purpose of this dissertation was to examine the impact that power imbalance has on safe sex practices among African American emerging adults. The objectives included: provide a thorough review of preexisting literature that explores the impact of power imbalance on safe sex practices among African American women; understand the impact that power imbalance has on safe sex practices among African American emerging adults comparing data from men and women; and understand if resilience is associated with power imbalance among African American emerging adult women in the United States. Utilizing a retrospective, cross-sectional, quantitative study design, three methods were used …


Psychometric Evaluation Of A Perceived Barriers To Medication Adherence Instrument And Association Between Perceived Barriers And Patient Characteristics, Lynn Andreae May 2024

Psychometric Evaluation Of A Perceived Barriers To Medication Adherence Instrument And Association Between Perceived Barriers And Patient Characteristics, Lynn Andreae

All ETDs from UAB

Medication adherence is an important component of diabetes management, yet nonadherence is common and has substantial patient and economic costs. In order to achieve meaningful improvements in medication adherence, clinicians and researchers need good ways of both identifying those at risk of nonadherence and ascertaining the specific reasons driving nonadherence in those patients. Current options for self-reported medication adherence are limited in their vulnerability to response bias, which may lead to overestimation of adherence. A measure that assesses perceived barriers to medication adherence may be a useful alternative, as it may identify patients at risk of nonadherence while reducing socially …


Examining Anti-Racist Attitudes In Maternity Care Workers, Angelina Aduke Toluhi Jan 2024

Examining Anti-Racist Attitudes In Maternity Care Workers, Angelina Aduke Toluhi

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Racism in maternity care has been identified as one of the major contributors to the persistent racial disparities in maternal health outcomes in the United States (US). Antiracism is a term used to describe the practice of actively identifying and opposing racism with the goal of changing policies, attitudes, behaviors, and beliefs that continue to foster racist ideas and actions. The results of this convergent mixed method research study reveal that racism and other forms of racial discrimination during maternity care may lead to adverse pregnancy outcomes in Non-Hispanic Black (NHB) pregnant patients in Southern US. In the first aim, …


Screening For And Addressing Social Determinants Of Health In Hospitals Participating In Accountable Care Organizations, Heather Lee Jan 2024

Screening For And Addressing Social Determinants Of Health In Hospitals Participating In Accountable Care Organizations, Heather Lee

All ETDs from UAB

There is a growing recognition among hospitals, payers, and policymakers in the United States that addressing social needs of patients is important to improving quality of care, patient outcomes, and lowering health care spending. Accountable care organizations (ACOs) may be especially incentivized to address social needs of patients to meet population health goals related to patient outcomes and costs. This cross-sectional study used data from the American Hospital Association Annual Survey to explore to explore how hospitals participating in or leading ACOs are screening for and addressing individual-level HRSNs of patients and to understand the extent to which ACOs are …


Understanding Disparities In Hypertension Treatment Cascade And Validating Blood Pressure Measurement Among Persons Living With Or At Risk For Hiv, Jessica Blair Jan 2024

Understanding Disparities In Hypertension Treatment Cascade And Validating Blood Pressure Measurement Among Persons Living With Or At Risk For Hiv, Jessica Blair

All ETDs from UAB

In the United States, 44% of adult women >18 years have hypertension. Although non-Hispanic Black adults were more likely to be aware of and treated for hypertension compared to non-Hispanic White adults, Black individuals had the highest prevalence of uncontrolled hypertension. Persons living with HIV have a higher prevalence of hypertension, which is a major modifiable risk factor for cardiovascular disease. Similar to the geographic distribution of hypertension in the US, people living in the South have higher incidence of both hypertension and HIV diagnoses compared to other US regions. Furthermore, accurate diagnosis of hypertension and initiation of treatment is …


Utilization Of Romosozumab During Covid-19 Pandemic Among U.S. Medicare Beneficiaries, Ye Liu Jan 2024

Utilization Of Romosozumab During Covid-19 Pandemic Among U.S. Medicare Beneficiaries, Ye Liu

All ETDs from UAB

Osteoporosis is increasingly recognized as a major public health issue in the aging U.S. population. Shortly after the licensure of romosozumab, an injectable medication indi-cated for women with postmenopausal osteoporosis at high risk of fracture administered by health care provider monthly, the COVID-19 pandemic broke out, which caused ma-jor disruptions to the delivery of health care across the nation. The pandemic dispropor-tionately affected minority and economically disadvantaged communities, exacerbating many pre-existing health disparities. Romosozumab has the highest dosing frequency among common injectable osteoporosis medications in the U.S. that require an office visit for injection, making romosozumab adherence more susceptible to …


Predictive Modeling Using Clinical Data And Compositional Microbiome Data, Li Zhang Jan 2024

Predictive Modeling Using Clinical Data And Compositional Microbiome Data, Li Zhang

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This dissertation focuses on developing predictive modeling using data from two areas: clinical data and microbiome data. Compositional data in real life are mainly represented by relative proportions. With the advancement of next-generation sequencing (NGS) technology, researchers can now collect a large volume of metagenomic sequencing data, which is valuable for investigating associations between the microbiome and host diseases. Current methods for dealing with such data are either constrained by generalization or limited by application. In the first part, to address this, we propose Bayesian compositional generalized linear models for analyzing microbiome data (BCGLM). This model incorporates a structured regularized …


Access To And Service Utilization Of Alabama Medicaid's Section 1115 Demonstration Waiver Program, Sarah Lee Bowler Jan 2024

Access To And Service Utilization Of Alabama Medicaid's Section 1115 Demonstration Waiver Program, Sarah Lee Bowler

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Background: Much research has been done investigating health disparities in the field of publicly-funding family planning. However, no longitudinal analysis has been conducted to examine the impact of Alabama Medicaid’s Section 1115 demonstration waiver on access to care, experience of barriers reported by enrollees, and repeat utilization of services. Methods: Medicaid enrollment and visit claims data were used to answer the questions related to access and service utilization. Annual Plan First survey data were used to investigate the experience of barriers to care among enrollees. For all three research questions, descriptive statistics were calculated, and linear probability models were used …


Using Hope To Cope: Chronic Stress, Religious Coping, And Masked Hypertension In African American Adults: The Jackson Heart Study, Miriam Miles Jan 2024

Using Hope To Cope: Chronic Stress, Religious Coping, And Masked Hypertension In African American Adults: The Jackson Heart Study, Miriam Miles

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USING HOPE TO COPE: CHRONIC STRESS, RELIGIOUS COPING, AND MASKED HYPERTENSION IN AFRICAN AMERICAN ADULTS: THE JACKSON HEART STUDY ABSTRACT Chronic stress experienced at home or work has been associated with acute increases in blood pressure (BP) measured in the doctor’s office. Few data are available on the association of chronic stress with BP measured outside of the office setting. Religious coping, applying religious beliefs to adapt to stressful situations, and functional and structural social support may protect against MHT by promoting active coping behaviors and increasing emotional well-being. High levels of religious involvement and high social support have been …


The Association Between Cardiovascular Disease Risk And Fractures In Postmenopausal Women, Rafeka Hossain Jan 2024

The Association Between Cardiovascular Disease Risk And Fractures In Postmenopausal Women, Rafeka Hossain

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Background: Fragility fractures pose a significant healthcare and economic burden in the United States. While age and bone mineral density (BMD) are the primary established risk factors for fragility fractures, the relationship between cardiovascular disease (CVD) and fractures remains underexplored. The primary objective of this analysis was to estimate the association of CVD risk with fractures in postmenopausal women. Methods: Utilizing 30 years of data from the WHI, Atherosclerotic Cardiovascular Disease (ASCVD) risk scores were computed using baseline age, race, systolic blood pressure, total cholesterol, high-density lipoprotein, diabetes, anti-hypertension medications, and smoking. Fracture outcomes encompassed any clinical fracture, major osteoporotic …


Trends In Reported Sexual Behaviors Among Alabama High School Students From 2011-2021, Sarah Franklin Jan 2024

Trends In Reported Sexual Behaviors Among Alabama High School Students From 2011-2021, Sarah Franklin

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Background: Sexual health education is associated with better outcomes among adolescents proper use of contraception, STI prevention methods, and lower rates of teenage pregnancy and STIs. In Alabama, sexual health education is not mandated in public schools. It is unknown how the lack of mandated sexual education has impacted trends in the sexual health of Alabama high school students. Methods: Using 2011-2021 data from the Youth Risk Behavior Survey (YRBS), this study evaluated trends in sexual behaviors, including: 1) sexual history, 2) current sexual activity, 3) risky or protective sexual behaviors, and 4) history of HIV testing, over time among …


Modifiable Risk Factors And Subsequent All-Cause And Cause-Specific Late Mortality After Blood Or Marrow Transplanta-Tion (Bmt), Nora Balas Jan 2023

Modifiable Risk Factors And Subsequent All-Cause And Cause-Specific Late Mortality After Blood Or Marrow Transplanta-Tion (Bmt), Nora Balas

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The objective of this dissertation was to examine the association between modifiable risk factors and subsequent all-cause and cause-specific late mortality among blood or marrow transplantation (BMT) recipients. I analyzed data for participants who were ≥18 years (y) at study participation from the BMT Survivor Study (BMTSS). BMTSS (U01 CA213140, PI: Bhatia) is a cohort study designed to examine the long-term outcome of individuals who survived ≥2y after undergoing BMT between 1974 and 2014, at the University of Alabama at Birmingham, City of Hope, or University of Minnesota. BMTSS also examines outcomes in an unaffected comparison group drawn from the …