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Articles 181 - 210 of 400
Full-Text Articles in Public Health
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 …
An Analysis Of Selecting Personal Protective Equipment Clothing Used In Foundries, Quachel Bazile
An Analysis Of Selecting Personal Protective Equipment Clothing Used In Foundries, Quachel Bazile
All ETDs from UAB
A foundry is a type of factory that deals with producing metal casting. The metals are casted in to shape by being melted into liquid and is then poured into the mold. Personal protective equipment (PPE) is worn to protect the worker from the hazard that engineering control cannot protect the worker from. A Private company wanted to evaluate their current PPE clothing to understand how well they protect a worker against molten metal splash PPE clothing was tested using the American Standard for Testing Material (ASTM) standard F955-07 entitled "Evaluating Heat Transfer through Materials for Protective Clothing upon Contact …
Three Studies On Cardiovascular Health: Modifiable Risk Factors And Health Expenditures In Medicare, Kristal Jo Aaron
Three Studies On Cardiovascular Health: Modifiable Risk Factors And Health Expenditures In Medicare, Kristal Jo Aaron
All ETDs from UAB
This dissertation comprises a series of studies conducted on modifiable risk factors as they contribute to cardiovascular health and disease and their associated health service expenditures and utilization. Specific topics in this compilation include (1) exploring the role of dietary sodium and potassium intake in cardiovascular health and disease; (2) examination of direct health expenditures in the Medicare-linked REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort as associated with Life’s Simple 7 (LS7), a composite measure of cardiovascular health defined by the American Heart Association (AHA) that is based on seven modifiable risk factors (blood pressure, blood cholesterol, …
Association Between Physical Activity And Learning, Pain Coping Strategies, Perceived Stress, And Depression Among Adults With Diabetes And Chronic Pain, Susan J. Andreae
Association Between Physical Activity And Learning, Pain Coping Strategies, Perceived Stress, And Depression Among Adults With Diabetes And Chronic Pain, Susan J. Andreae
All ETDs from UAB
In addition to the role of physical activity (PA) in the prevention of chronic disease and premature death, PA may have psychosocial benefits. We examined the association between four different domains of PA and three outcomes that may contribute to the emotional and mental well being of individuals. This is a secondary analysis of community dwelling adults with diabetes and chronic pain in which we examined the association between four domains of PA and learning (measured using diabetes knowledge, self efficacy in diabetes and pain management), pain coping strategies, perceived stress, and depression. Regression models were used to model changes …
Characteristics And Behaviors Based On Introduction To Opioids Among Adults In Buprenorphine/Naloxone Treatment, Angela R. Gallien
Characteristics And Behaviors Based On Introduction To Opioids Among Adults In Buprenorphine/Naloxone Treatment, Angela R. Gallien
All ETDs from UAB
Buprenorphine/naloxone (BNT) is a pharmacological treatment for opioid use disorders and is available by prescription in an office-based setting from physicians with specialized training. The purpose of this study was to identify the characteristics and behaviors among adults on BNT with the intent to identify the linear combination of variables that account for the differences based on the origins of opioid use. Four opioid user groups were identified a priori: recreational users (RU); self-treaters (ST); medical users misusing (MUM); and medical users not misusing (MU). The dependent variables were mental health and mood, pain and medical problems, internal or external …
Development Of A Conceptual Framework For Pediatric Preparedness Healthcare Coalitions: A Pilot Study, Bryan K. Breland
Development Of A Conceptual Framework For Pediatric Preparedness Healthcare Coalitions: A Pilot Study, Bryan K. Breland
All ETDs from UAB
Natural or man-made disasters overwhelm the resources of a healthcare organization and strain or compromise the provision of medical services to rapidly expanding patient populations. Public and private healthcare organization routinely plan and exercise systems and responses intended to bolster medical care capabilities and increase the capacity of the organization during crisis events. Providers of pediatric emergency medical service are particularly vulnerable to disaster surge, since many pediatric emergency services operate consistently at near capacity. In recent years, policy-makers and medical professionals have begun to look toward healthcare coalitions as a mechanism to rapidly expand resources and capacity for patient …
An Examination Of Farm-To-Consumer Retail Outlet Usage Among Participants Of The Special Supplemental Nutrition Program For Women, Infants, And Children (Wic) In Birmingham, Al, Chelsea Renee Singleton
An Examination Of Farm-To-Consumer Retail Outlet Usage Among Participants Of The Special Supplemental Nutrition Program For Women, Infants, And Children (Wic) In Birmingham, Al, Chelsea Renee Singleton
All ETDs from UAB
Disparities in the neighborhood retail food environment have been hypothesized to be associated with poor diet quality and adverse health outcomes such as obesity. Studies have found that lower income communities often have reduced access to affordable healthy foods. In 2009, the Centers for Disease Control and Prevention proposed direct farm-to-consumer (FTC) retail outlets (i.e. farmers markets, farm/roadside stands, community gardens and community supported agriculture programs) as a potential strategy to alleviate retail food environment disparities in communities with limited resources. Information on the behavioral and health implications of FTC outlet usage by lower income individuals is limited. This research …
The Influence Of Personal, Interpersonal, And Community Factors On The Parenting Self-Efficacy Of First-Time Mothers, Tamika L. Smith
The Influence Of Personal, Interpersonal, And Community Factors On The Parenting Self-Efficacy Of First-Time Mothers, Tamika L. Smith
All ETDs from UAB
The Social Ecological Model (SEM) allows for examining human behavior and the factors that influence behavior change in totality. In addition, the model offers guidance in identifying the factors that may lead to a change in or explanation of behavior. This study utilizes SEM to identify factors at the personal, interpersonal, and community level in order to determine the relationship between specific ecological factors and parenting self-efficacy. Furthermore, the study examines the predictive quality of the ecological factors on parenting self-efficacy. Data collected from the Parenting for the First-time Project (PFT) was used. PFT is a multi-site longitudinal study of …
Cost Effectiveness Of Hypertension Treatment: New Model, Methods, And Focus On African Americans, Gabriel Saidimu Tajeu
Cost Effectiveness Of Hypertension Treatment: New Model, Methods, And Focus On African Americans, Gabriel Saidimu Tajeu
All ETDs from UAB
This dissertation focuses on the potential benefits of hypertension (HTN) treatment for the general population and African Americans (AAs) specifically. We undertake three research projects that are interconnected. First, using a systematic review methodology we assess the current state of the cost-effectiveness of HTN treatment literature in order to identify potential gaps in the cost-effectiveness literature, methodological shortcomings, and provide policy makers and researchers with a summary of the current findings as well as methods used in the literature. Second, building off our findings in paper 1, we construct a cost-effectiveness model. We assess the cost-effectiveness of HTN treatment not …
Count Models With Multiple Inflations, Arvind Tripathi
Count Models With Multiple Inflations, Arvind Tripathi
All ETDs from UAB
The goal of this research is to develop new statistical models for the analysis of count data even if data exhibit over dispersion or under dispersion and has multiple inflated counts. Although many statistical models are available for the analysis of count data, there is no available statistical model that can address the presence of more than expected multiple counts together with over/under dispersion. In our first paper, we develop a multiple-inflation negative binomial (MINB) model and use the expectation maximization (EM) algorithm along with a numerical optimization to obtain maximum likelihood estimates. We applied the one step smoothly clipped …
Exploring Body Image And The Association Between Body Image Dissatisfaction And Waist Circumference Among Overweight And Obese Rural African American Women Participating In A Weight Loss Program, Erica Rayshelle Johnson
Exploring Body Image And The Association Between Body Image Dissatisfaction And Waist Circumference Among Overweight And Obese Rural African American Women Participating In A Weight Loss Program, Erica Rayshelle Johnson
All ETDs from UAB
African American (AA) women are disproportionately burdened by obesity, an epidemic with implications that reach beyond physiological consequences. Given that perceptions of body image may impact health-promoting behaviors and weight management efforts, we sought to evaluate the presence and magnitude of body image dissatisfaction (BID) and explore its relationship with waist circumference (WC), independent of weight among overweight and obese treatment-seeking rural AA women. Participants referred to images from the Pulvers Figure Rating Scale that included nine body silhouettes to answer: “How I think I look now” (i.e., current body image) and “How I would like to look” (i.e., desired …
Prevalence And Determinants Of High Risk Human Papillomavirus (Hpv) Among Wives Of Migrant Workers - A Study In Far - West Nepal, Derek Johnson
Prevalence And Determinants Of High Risk Human Papillomavirus (Hpv) Among Wives Of Migrant Workers - A Study In Far - West Nepal, Derek Johnson
All ETDs from UAB
This dissertation research focuses on the risk factors associated with high-risk HPV infection (HR-HPV) and abnormal cervical cytology in Nepali women residing in Nepal’s Far-West district of Achham. The first part of this dissertation assesses the HR-HPV test concordance of self-collected vs. clinician-collected cervico-vaginal specimens. Of 261 women with both clinician- and self-collected cervical samples, 25 tested positive for HR-HPV, resulting in an overall HR-HPV prevalence of 9.6% (95% Confidence Interval [CI]: 6.3 – 13.8). The overall Kappa value for clinician- and self-collected tests was 0.64 (95% CI: 0.48 – 0.84), indicating a “good” level of agreement. The second part …
Statistical Methodology To Improve The Understanding Of Dna Methylation Data, Lindsay Leigh Waite Jones
Statistical Methodology To Improve The Understanding Of Dna Methylation Data, Lindsay Leigh Waite Jones
All ETDs from UAB
The study of epigenetics involves the investigation of genomic elements that do not directly affect DNA sequence but are stable and preserved during cell division. One of the most commonly studied epigenetic elements is DNA methylation, which occurs when a methyl group is added to a cytosine residue in the DNA sequence. The advancement of technology to quantify DNA methylation, including bisulfite sequencing and bisulfite microarrays, has led to a large amount of available data. However, many questions still remain as to how to statistically analyze this data. This dissertation addresses some statistical concerns related to the analysis of DNA …
Evaluation Of Sample Size Re-Estimation Procedures For Non-Inferiority Designs With Time-To-Event Outcomes, Hwasoon Kim
Evaluation Of Sample Size Re-Estimation Procedures For Non-Inferiority Designs With Time-To-Event Outcomes, Hwasoon Kim
All ETDs from UAB
Study designs that allow sample size review may potentially save a study by identifying misspecified assumptions, modifying the planned sample size, and reinforcing the study’s power. Most sample size re-estimation (SSR) methods in non-inferiority trials have been developed for continuous or binary outcomes. In many medical domains studying cancer, heart failure, and other chronic diseases, most phase III trials use censored endpoints (e.g. survival or event-free survival). Non-inferiority designs have inherent complexity by the introduction of the non-inferiority margin and therefore understanding of strategies in these methods is essential. In our first paper, we detail the issues related to misspecification …
Spatial Analysis Of Hypertension Prevalence Using A Large Us Cohort, Matthew Loop
Spatial Analysis Of Hypertension Prevalence Using A Large Us Cohort, Matthew Loop
All ETDs from UAB
Stroke mortality rates are highest in the Southeast US, and the cause for this "Stroke Belt" is not well understood. We investigate the spatial distribution of hypertension, an important risk factor for stroke. This investigation explores statistical issues in performing spatial analysis in a large cohort (over 30,000 participants), relating to type 1 error rate control and geocoding error. Recommendations for handling these statistical issues are made. In an applied analysis, we find that hypertension prevalence varies across the continental US, and is highest in northeast Louisiana, southeast Arkansas, west Mississippi, and east Michigan. These areas are not concordant with …
Assessing Potential Diesel Exhaust Exposure In Truckers Resting At Truck Stops, Gumindenga Farayi Mabvuta
Assessing Potential Diesel Exhaust Exposure In Truckers Resting At Truck Stops, Gumindenga Farayi Mabvuta
All ETDs from UAB
The nature of long haul truck driving places workers in this occupation in a peculiar setting for chronic exposure to diesel exhaust which is a known carcinogenic. These drivers endure exposure to diesel exhaust in traffic and potentially greater exposure at truck stops where they park for rest breaks as mandated by DOT regulations. This study looked at the potential exposure to diesel exhaust in long haul truck drivers resting at truck stops where up to two hundred trucks are left idling for air conditioning and other reasons. Two different trucks were used consecutively over the 21 days of sampling. …
Some Contributions To Bayesian Regularization Methods With Applications To Genetics And Clinical Trials, Himel Mallick
Some Contributions To Bayesian Regularization Methods With Applications To Genetics And Clinical Trials, Himel Mallick
All ETDs from UAB
Variable selection refers to the class of problems where one tries to find an optimal subset of relevant variables, which can be used to accurately predict the outcome of a certain response variable. Typically, a large number of variables are often collected; however, all but a few important variables are relevant for the prediction of the outcome, so the underlying representation is sparse. To this end, variable selection is fundamental in high-dimensional data analysis, playing a crucial role in important scientific discovery and decision-making, and has received enormous attention in the literature. Regularization method is one attractive approach that has …
Non-Compliance In Clinical Trials: The Perils Of Statistical Methods, Peter Drew Merrill
Non-Compliance In Clinical Trials: The Perils Of Statistical Methods, Peter Drew Merrill
All ETDs from UAB
All clinical trials must deal with protocol deviations that occur during the course of the study. One of the most important deviations is non-compliance to treatment assignment. Intention to treat (ITT) is the most commonly employed method to deal with non-compliance in a clinical trial; however, it provides biased estimates of the effect of receiving the treatment. Other methods such as per protocol (PP) and as treated (AT) provide alternatives to ITT. PP and AT, assume an all-or-nothing compliance situation. However, the possibility of being partially compliant to a treatment is common. We investigate possible approaches to incorporating partial compliance …