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The Impact Of Meal Timing On Cardiometabolic Syndrome Indicators In Shift Workers, Hylton Elisabeth Molzof Jan 2015

The Impact Of Meal Timing On Cardiometabolic Syndrome Indicators In Shift Workers, Hylton Elisabeth Molzof

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Shift workers exhibit a greater risk for several cardiovascular and metabolic diseases including heart disease, obesity, hypertension, and type II diabetes (Boivin, Tremblay, & James, 2007; Chen, Lin, & Hsiao, 2010; Knutsson, Jonsson, Akerstedt, & Orth-Gomer, 1986; Kroenke et al., 2007). Shift workers have been reported to consume more pro-inflammatory diets than day workers (Wirth, Burch, Shivappa, Steck, et al., 2014) and to redistribute their food intake to the night during work (Lennernas, Hambraeus, & Akerstedt, 1995; Pasqua & Moreno, 2004). Numerous studies in animal models and humans have shown that eating during the sleep or inactive period is associated …


Presence And Mobilization Of Staphylococcus Aureus Pathogenicity Islands (Sapis) Among Bovine Mastitis Isolates, Laura Kate Parker Jan 2015

Presence And Mobilization Of Staphylococcus Aureus Pathogenicity Islands (Sapis) Among Bovine Mastitis Isolates, Laura Kate Parker

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Bovine mastitis is inflammation of the mammary gland that occurs in cattle, as a result of invading bacteria. Staphylococcus aureus, a causative agent of bovine mastitis, produces toxins such as the toxic shock syndrome toxin (TSST-1) and the staphylococcal enterotoxins (SEs). The genes for these toxins are coded on S. aureus pathogenicity islands (SaPIs), which are mobile genetic elements associated with virulence factors. SaPIs can be mobilized by bacteriophages, resulting in the production of transducing particles that can spread virulence factors throughout a bacterial population. This research assessed the role and prevalence of SaPIs among bovine mastitis samples. In this …


Examining Parental And Neighborhood Factors As Moderators In A Youth Violence Prevention Pilot Study, Kendra Piper Jan 2015

Examining Parental And Neighborhood Factors As Moderators In A Youth Violence Prevention Pilot Study, Kendra Piper

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Youth violence is a significant and prevalent public health concern in the United States. Adolescents and young adults have the highest rates of violent crime perpetration and victimization. Youth violence is a complex problem involving multiple levels of influence that interact to diminish or increase risk and protective factors in high risk communities. Family and neighborhood factors have emerged as prominent influences on the risk of violent and delinquent behavior. Approaches to reducing risk behaviors in adolescence have moved beyond traditional risk-factor reduction to emphasize the importance of enhancing protective factors. Positive youth development programs have been found to be …


Trends, Market Correlates, And The Impact Of Health Information Exchange, Saurabh Rahurkar Jan 2015

Trends, Market Correlates, And The Impact Of Health Information Exchange, Saurabh Rahurkar

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The purpose of this dissertation is to examine the effects of Health Information Exchange (HIE) as well to evaluate hospital and market characteristics related to trends in HIE adoption. Widespread HIE is believed to boost efficiency, reduce health care costs, and improve outcomes; as such numerous efforts have aimed to promote and facilitate HIE by providers. Despite this, over a quarter of all hospitals in the U.S. do not participate in HIE and thus it is essential to examine the evidence for the theorized benefits from HIE. As such, the first paper systematically reviews the literature examining the relationship of …


The Investigation Of Quality Of Life, Perceived Disease Severity, And Adherence In Patients With The G551d Mutation Receiving Ivacaftor Therapy, Heather Young Hathorne Jan 2015

The Investigation Of Quality Of Life, Perceived Disease Severity, And Adherence In Patients With The G551d Mutation Receiving Ivacaftor Therapy, Heather Young Hathorne

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Cystic fibrosis (CF), a genetic disorder, is a chronic life threatening illness that affects 30,000 adults and children in the United States and 70,000 worldwide. Treatment for CF is complex and consuming, consisting of multiple time intensive regimens. The therapy regimen has been descried as extraordinary when compared even to therapy regimens for other chronic illnesses. Oral and nebulized medication therapy, airway clearance therapy, pancreatic enzyme replacement therapy and vitamin /nutritional supplements are all required for the multiorgan treatment regimen for CF. Daily prescribed therapy can include as many as 40-50 pills, breathing treatments lasting up to tow hours a …


Obesity And Mortality In Us-Residing Hispanic Adults, Carrie Howell Jan 2015

Obesity And Mortality In Us-Residing Hispanic Adults, Carrie Howell

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Previous epidemiological studies observed the lack of an association between increased body mass index (BMI: kg/m2) and all-cause mortality in US-residing Hispanic adults. The purpose of this dissertation was to examine the validity of three hypothesized explanations for the absence of significant associations. Using data on Hispanic participants from the National Health and Nutrition Examination Survey (NHANES) [1988-1994 and 1999-2004] and the National Health Interview Survey (NHIS), this dissertation examined whether: (1) BMI was associated with cause-specific mortality; (2) measures of body composition was associated with all-cause mortality; and (3) the BMI-all-cause mortality association differed as a function of Hispanic …


Practical Extensions Of The Continual Reassessment Method, Amber Salter Jan 2015

Practical Extensions Of The Continual Reassessment Method, Amber Salter

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This dissertation considers the presence of patient heterogeneity in dose finding studies using the likelihood-based time to event continual reassessment method (TITE-CRM). First, assuming group membership is known and the groups share some information regarding their maximum tolerated dose (MTD), we extend the two-group two-parameter CRM to the TITE-CRM. We examine the performance of the two-group two-parameter TITE-CRM for various scenarios where the true MTD for each group is different. We also consider the situation where the groups are truly homogeneous but a heterogeneous model is employed. Our simulations show that the method has some loss in accuracy compared to …


Combinatorial Effects Of Corexit 9500a And Temperature Stressors On Embryo Development In The Zebrafish Danio Rerio, Erica Davis Anderson Jan 2014

Combinatorial Effects Of Corexit 9500a And Temperature Stressors On Embryo Development In The Zebrafish Danio Rerio, Erica Davis Anderson

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the Kemp’s Ridley Recovery Program during the 2005-2008 nesting seasons. This


Interaction Between A Low-Iron Diet And Early-Life Methylmercury Exposure In Daphnia Pulex, Sherri Hudson Jan 2014

Interaction Between A Low-Iron Diet And Early-Life Methylmercury Exposure In Daphnia Pulex, Sherri Hudson

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Methylmercury (MeHg) is a known neurotoxicant and bioaccumulates in fish, with exposure to humans in utero being of highest concern. Iron deficiency (ID) accounts for approximately 50% of anemia cases. Anemia is estimated to affect 1.62 billion people worldwide, and is particularly problematic during pregnancy and early life. Previous studies have shown that ID exacerbates toxicity associated with exposure to metals, including lead, manganese, and cadmium. The overall purpose of this thesis research is to investigate the interaction between a low-iron (Fe) diet and early-life exposure to MeHg in Daphnia pulex. I hypothesized when D. pulex are fed a low-Fe …


Urbanization And Land-Use Change In Puerto Maldonado, Peru: Categorizing The Landscape Using High-Resolution Satellite Imagery For Potential Use In Public Health Research, Laura Brianna Gast Jan 2014

Urbanization And Land-Use Change In Puerto Maldonado, Peru: Categorizing The Landscape Using High-Resolution Satellite Imagery For Potential Use In Public Health Research, Laura Brianna Gast

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Environmental change, especially rapid urbanization, has measurable effects on human health. Over 70 percent of the global population is expected to live in urban areas by 2025, and at least 1 in 3 of these individuals will live in extreme poverty. Living in a slum or shantytown exposes individuals to health and safety risks including inadequate sanitation, lack of access to clean water, air pollution, violence, over-crowding and risk of infectious disease. Remote sensing technologies are an effective tool for detection and prediction of areas with significant land use change, which enables identification of populations with the highest risk of …


A Spatiotemporal Model For Repeated Imaging Data, Brandon George Jan 2014

A Spatiotemporal Model For Repeated Imaging Data, Brandon George

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Longitudinal imaging studies have increased in popularity as clinical researchers seek to investigate how phenomena within the body change over time. Analysis of data from these studies is complicated by correlation between repeated measures over time and different locations in the body. To address this problem we propose the use of a linear model with a separable parametric correlation structure. This model considers spatial and temporal correlation independently and incorporates the correlation using parametric functions that have the potential to be much more efficient than an unstructured approach. Our model also has the ability to control for time- and space-varying …


Relationship Between Diabetes And Indoor Air Pollution: An Exploratory Analysis, Sandeep Mishra Jan 2014

Relationship Between Diabetes And Indoor Air Pollution: An Exploratory Analysis, Sandeep Mishra

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India has the second highest number of people with diabetes. The high prevalence of diabetes in India cannot be explained on the basis of established risk factors like obesity. The role of air pollution in diabetes has recently received attention. Studies have indicated the possibility that air pollution generated by traffic might be associated with increased risk of diabetes. Published literature lacks studies that assess the relationship between indoor air pollution and diabetes, although indoor air pollution can lead to higher levels of pollutants in house compared to traffic pollution. The current study determined the relationship between indoor air pollution …


Three Studies On Family Meals: Examining The Predictors Of Family Meals And Its Impact On Adolescent Health, Samantha Sittig Goldfarb Jan 2014

Three Studies On Family Meals: Examining The Predictors Of Family Meals And Its Impact On Adolescent Health, Samantha Sittig Goldfarb

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This three-manuscript dissertation addresses gaps in the literature related to the predictors of family meals and its impact on adolescent health behavior. Sharing dinner as a family has been promoted by the media and many researchers as an ideal environment to enrich the parent-child bond and subsequently reduce adolescent risk behaviors such as substance use and delinquency. This dissertation centers on three topics, in particular: (1) the nature of the family meal literature given the multiple adolescent health behavior outcomes, study designs, and model types investigated and used by researchers, (2) the impact of family dinners on adolescent school problems, …


Acculturation And Social Support As Predictors Of Physical Activity In A Web-Based Intervention For Latinas, Tanya Benitez Jan 2014

Acculturation And Social Support As Predictors Of Physical Activity In A Web-Based Intervention For Latinas, Tanya Benitez

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Latinas in the United States report high levels of physical inactivity and are disproportionately burdened by associated chronic diseases, demonstrating the need for innovative approaches to reducing these disparities. The purpose of the current study was to evaluate self-reported changes in physical activity and social support, and to examine the association between physical activity and acculturation, following a one month culturally and linguistically adapted, theory-driven (Social Cognitive Theory and Transtheoretical Model) Internet-based physical activity intervention for Latina adults. Data was collected from Spanish-speaking Latinas (N=24) between the ages of 21-61 years (M=35.17, SD=11.22) enrolled in a web-based physical activity pilot …


Predictors Of Outcomes In Patients With Ventricular Assist Devices, Amelia Katharine Boehme Jan 2014

Predictors Of Outcomes In Patients With Ventricular Assist Devices, Amelia Katharine Boehme

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Ventricular assist devices (VAD) are used as a bridge to transplant and to increase the quality of life in advanced heart failure patients. The use of the VAD is not without risks itself, with an increased risk of thromboembolism, hemorrhage and death. Therefore, we aimed to (1) evaluate predictors of thromboembolism; (2) design a score to predict hemorrhages in VAD patients; and (3) evaluate the change in kidney function post-VAD implant and to investigate the relationship between kidney function and mortality in VAD patients using data collected from the University of Alabama at Birmingham Mechanical Circulatory Support Clinic. Over the …


Exposure To Methylmercury Via Fish Consumption In Ghana And An Evaluation Of Methylmercury Toxicity Under A Low Food Ration In Daphnia Pulex, Dzigbodi Adzo Doke Jan 2014

Exposure To Methylmercury Via Fish Consumption In Ghana And An Evaluation Of Methylmercury Toxicity Under A Low Food Ration In Daphnia Pulex, Dzigbodi Adzo Doke

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For many people of the world, fish is a primary source of protein, especially in countries like Ghana, where about 60% of the protein consumed is derived from fish. Fish advisories have been established by some nations to protect the public from harmful health effects linked to eating contaminated fish. Methylmercury (MeHg) is one such contaminant that has resulted in fish advisories. Fish advisories have not been developed in Ghana, although MeHg contamination of aquatic ecosystems is likely due to the long history of mercury (Hg) use in artisanal gold mining. To address this gap in our knowledge, I compiled …


Effects Of Early Life Exposure To Methylmercury On Predator Response In Daphnia Pulex, Megan Lisa Steed Jan 2014

Effects Of Early Life Exposure To Methylmercury On Predator Response In Daphnia Pulex, Megan Lisa Steed

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Knowledge of the health effects of toxic chemicals is largely based on single chemical models rather than a multi-factor model, which more accurately captures realworld exposures. This study investigated how methylmercury affects Daphnia pulex in the presence of predatory stress chemical. A kairomone is an infochemical released by an animal that can be detected by another animal. Daphnia pulex detects kairomone released by Danio rerio resulting in the induction of morphological and life history changes. Danio rerio were kept in COMBO media for 24 hours at a density of 2 fish per liter. Daphnids were then housed in kairomone-containing COMBO …


Socio-Demographic Characteristics, Medical Indications, And Perinatal Outcomes Associated With Interventional Early Term Delivery, Kelley Swatzell Jan 2014

Socio-Demographic Characteristics, Medical Indications, And Perinatal Outcomes Associated With Interventional Early Term Delivery, Kelley Swatzell

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The results indicate an approximate 75% female bias being produced in the egg corral.


Association Of Blood Pressure Phenotypes With Kidney Disease, Rikki M. Tanner Jan 2014

Association Of Blood Pressure Phenotypes With Kidney Disease, Rikki M. Tanner

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model. The sex ratios produced in the fluctuating temperature experiments were not


Evaluation Of Environmental Factors And Dengue Fever In Sri Lanka Using Geospatial Tools, Meghan Tipre Jan 2014

Evaluation Of Environmental Factors And Dengue Fever In Sri Lanka Using Geospatial Tools, Meghan Tipre

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The incidence of dengue fever has increased exponentially in Sri Lanka, from 24.4 cases per 100,000 in 2003 to 165.3 per 100,000 population in 2013. Despite concerted effort by the Sri Lankan government, dengue control remains a challenge in the country, indicating a need for novel approach for dengue prevention and control. The aim of this research was to identify environmental risk factors that may be associated with dengue incidence rate at the Gram Niladhari Divisions level (smallest administrative unit) in Colombo city, Sri Lanka, using geospatial tools such as remote sensing and geographic information system. These factors included climate …


An Evaluation Of Sample Size Re-Estimation Adaptive Designs And Delayed-Start Designs For Alzheimer's Disease Trials, Guoqiao Wang Jan 2014

An Evaluation Of Sample Size Re-Estimation Adaptive Designs And Delayed-Start Designs For Alzheimer's Disease Trials, Guoqiao Wang

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The goal of this dissertation is to investigate the effect of novel clinical trial designs for Alzheimer's disease (AD), and to provide applications for their use in real trials. The data used for our simulation is a meta-data base of completed trials. In the first paper, we investigate the sample size re-estimation (SSR) adaptive design based on the effect size and the variance without taking into account the longitudinal feature of the trials. In the second paper, we take advantage of that feature to explore the SSR based on the variance of the rate of change in the longitudinal measurements. …


New Niosh Headforms: Developing Novel Methods For Fabricating A More Realistic Physical Headform And Custom Facepieces And Evaluating Existing Commercially-Available Respirators, Paula Susanne Joe Jan 2014

New Niosh Headforms: Developing Novel Methods For Fabricating A More Realistic Physical Headform And Custom Facepieces And Evaluating Existing Commercially-Available Respirators, Paula Susanne Joe

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For over 30 years, respirator sizing has been based on an anthropometric survey performed by LANL using the young and predominantly Caucasian US Air Force personnel. NIOSH, having observed the increase in diversity in the workplace, began a new survey in 2003 weighted to the US census. Finding that the LANL panel was no longer representative of the modern workforce, a new fit test panel recommending five sizing categories was created in 2007. Anthropometrically accurate headforms three-dimensional models for the average face in each size were designed in 2010. While these headforms are intended for use in respirator design, it …


The Small Sample Inferences Of Cluster-Randomized Trials, Peng Li Jan 2014

The Small Sample Inferences Of Cluster-Randomized Trials, Peng Li

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Generalized estimating equation (GEE) and generalized linear mixed model (GLMM) are two statistical modeling methods commonly used in the analyses of correlated outcomes from cluster-randomized trials (CRTs). The fact that most CRTs involve only a small number of clusters makes the small sample adjustment critical to preserve the type I error rates in testing the null hypothesis of intervention effects. To improve the small sample performance of GEE, some bias-corrected sandwich estimators have been proposed. To improve the small sample performance of GLMM, the approximated Wald F test is used to replace the asymptotic ÷^2 test and the denominator degrees …


Power Issues And Internal Pilot Designs For Cluster-Randomized Trials With Unequal Cluster Sizes, Ashutosh Ranjan Jan 2014

Power Issues And Internal Pilot Designs For Cluster-Randomized Trials With Unequal Cluster Sizes, Ashutosh Ranjan

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Cluster-randomized trials that randomize groups of individuals, instead of individuals themselves, run the risk of being underpowered when they are designed assuming equal cluster sizes but end up recruiting unequal clusters. The loss in power of the trial is directly related to the amount of variation present among the cluster sizes. To overcome the loss in power, researchers often employ a weighted analysis of the cluster means. Different weighting procedures have been developed that appear to maintain the power of the trial but there have been fewer attempts to describe the impact of different weights on the type I error …


Predictors Of Smoking Cessation Among Dental Patients Participating In A Web-Assisted Tobacco Intervention: A National Dental Practice-Based Research Network Study, Midge N. Ray Jan 2014

Predictors Of Smoking Cessation Among Dental Patients Participating In A Web-Assisted Tobacco Intervention: A National Dental Practice-Based Research Network Study, Midge N. Ray

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MIDGE N. RAY HEALTH PROMOTION AND EDUCATION ABSTRACT Nicotine addiction is a chronic and relapsing disease that has serious health consequences. Tobacco continues to be the leading preventable cause of morbidity and mortality in the United States. In 2010, approximately 58.3 million Americans were identified as cigarette smokers. This study was part of the Hygienists' Internet Tobacco Cessation Study (Hi Quit), a randomized controlled trial that employed a web-assisted tobacco intervention (WATI) called Decide2Quit to assist smokers in quitting. Smokers (N=258) were enrolled in the study by dental practices (N=100) that referred patients who smoke to the website. The control …


A Mixed Methods Study Of Health Literacy And Its Role In Hpv Vaccine Uptake Among College Students, Michelle Sharonda Williams Jan 2014

A Mixed Methods Study Of Health Literacy And Its Role In Hpv Vaccine Uptake Among College Students, Michelle Sharonda Williams

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Health literacy includes the ability to understand and process written and spoken health information, and numbers and calculations related to health information. Low health literacy is associated with negative health outcomes, and poor patient-provider communication. In order to advance health literacy research, there is a need to assess health literacy comprehensively and to develop an understanding of how health literacy impacts people at various stages of their lives. A sequential explanatory mixed methods study was conducted to assess college students' health literacy. During the quantitative phase, the Short Test of Functional Health Literacy in Adults (S-TOFHLA), the Newest Vital Sign …


Statistical Analysis In Genomic Studies, Guodong Wu Jan 2014

Statistical Analysis In Genomic Studies, Guodong Wu

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Next-generation sequencing (NGS) technologies reveal unprecedented insights about genome, transcriptome, and epigenome. However, existing quantification and statistical methods are not well prepared for the coming deluge of NGS data. In this dissertation, we propose to develop powerful new statistical methods in three aspects. First, we propose a Hidden Markov Model (HMM) in Bayesian framework to quantify methylation levels at base-pair resolution by NGS. Second, in the context of exome-based studies, we develop a general simulation framework that distributes total genetic effects hierarchically into pathways, genes, and individual variants, allowing the extensive evaluation of existing pathway-based methods. Finally, we develop a …


Statistical Methods For Set-Based Association Tests In Genetic Studies, Qi Yan Jan 2014

Statistical Methods For Set-Based Association Tests In Genetic Studies, Qi Yan

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This dissertation research focuses on developing statistical methods for set-based association tests at both pathway and gene levels in genetic studies. Set based analysis considers the biological hierarchical structure, while traditional genome-wide association studies usually focus on single-marker analysis which only access marginal effect. Therefore, pathway analysis may potentially complement single-marker analysis and provide additional insights for the genetic architecture of complex diseases. In the first study, we propose a novel way for pathway analysis that assesses the effects of genes using the sequence kernel association test (SKAT) and the effects of pathways via an extended adaptive-rank-truncated product statistic. For …


Patient And System Level Factors As Predictors Of Adherence To Antiretroviral Therapy Appointment Schedules In Cambodia, Gary T. Daigle Jan 2014

Patient And System Level Factors As Predictors Of Adherence To Antiretroviral Therapy Appointment Schedules In Cambodia, Gary T. Daigle

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PATIENT AND SYSTEM LEVEL FACTORS AS PREDICTORS OF ADHERENCE TO ANTIRETROVIRAL THERAPY APPOINTMENT SCHEDULES IN CAMBODIA GARY T. DAIGLE EPIDEMIOLOGY / INTERNATIONAL HEALTH ABSTRACT On-time attendance at clinical appointments by patients on antiretroviral therapy (ART) is essential to the prevention of medication interruptions, viral rebound, drug resistance, and long term mortality. An observational study conducted in 2010, Enablers and Adherence to Antiretroviral Therapy in Cambodia, sought to identify factors that predict on-time clinical appointment attendance by patients on ART. These factors were classified as either ART patient level factors (e.g. demographic, clinical) or patient care and support system level factors …


Molecular Profiling In Cervical Carcinogenesis And Progression, Kathryn Elizabeth Royse Jan 2014

Molecular Profiling In Cervical Carcinogenesis And Progression, Kathryn Elizabeth Royse

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Coexisting lesions can reduce genomic heterogeneity in precancer progression analysis by reducing variation and bias that can mask gene effects. Our goal was to use novel methodologies to depict the neoplastic stage effect (Normal v. LSIL v. HSIL) in cervical precancer. We analyzed the neoplastic stage effect via in silico and in vivo methodologies. For in silico analyses, we calculated differential expression (DE) estimates from a systematic review of DNA methylation and gene expression literature. Significant genes (FC≤2.0 or p-value≥0.05) were grouped by histology for pathway analysis. For in vivo analyses, we performed RNA-seq on microdissected FFPE coexisting cervical tissue …