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Articles 31 - 60 of 400
Full-Text Articles in Public Health
Unintended Pregnancy, Postpartum Contraception, And Healthcare Utilization Among Young Married Women Affected By Hiv In Kenya, Liza M. Kimbo
Unintended Pregnancy, Postpartum Contraception, And Healthcare Utilization Among Young Married Women Affected By Hiv In Kenya, Liza M. Kimbo
All ETDs from UAB
Women with an unintended pregnancy are at risk of a repeat unintended pregnancy. Although use of postpartum contraception is an effective way to prevent repeat unintended pregnancies, the majority of unintended pregnancies globally occur in women who are not using contraception. Unintended pregnancies can have negative health and social consequences for both women and their children. This study aimed to better understand the use of postpartum contraceptives and healthcare services by married women with unintended versus intended pregnancy in south-western Kenya, with a special focus on young women. The study followed an exploratory sequential mixed methods design. In the first …
The Impact Of Diabetes On At-Fault Motor Vehicle Collisions In Older Adults: Visual Function, Medication, And Crash Characteristics, Thomas A. Swain
The Impact Of Diabetes On At-Fault Motor Vehicle Collisions In Older Adults: Visual Function, Medication, And Crash Characteristics, Thomas A. Swain
All ETDs from UAB
Older drivers represent one of the fastest growing age groups of drivers in the United States. Crash risk among older adults, who have the highest prevalence of vision impairment, has been shown to be related to worse visual function. Diabetes mellitus is a chronic health condition affecting more than 23.1 million Americans, and one in three have pre-diabetes. Persons with diabetes are at increased risk of conditions which cause vision loss. Research indicates those with diabetes have higher rates of MVCs. Despite the increased MVC risk among each of these groups, work has yet to evaluate if diabetes modifies the …
Genetic And Epigenetic Risk Scores For Chronic Kidney Disease In African Americans, Alana C. Jones
Genetic And Epigenetic Risk Scores For Chronic Kidney Disease In African Americans, Alana C. Jones
All ETDs from UAB
Kidney disease is the tenth-leading cause of death in the United States (US). There are significant racial disparities within kidney disease: African Americans (AAs) have the highest rates of CKD and carry a four-fold higher risk of developing end-stage renal disease (ESRD). They are also less likely to undergo kidney transplants, and among those who do, are more likely to experience graft rejection. Additionally, until 2021, kidney function equations were shown to underestimate the severity of kidney disease in AA due to the use of race coefficients. Among all populations, genetic and epigenetic factors contribute to kidney disease. However, AAs …
The Effect Of Weather Events On Dengue Fever In Brazil 2014-2022, Maryclare Gabel
The Effect Of Weather Events On Dengue Fever In Brazil 2014-2022, Maryclare Gabel
All ETDs from UAB
Dengue fever is a mosquito-borne infectious disease that is spread through the bite of an infected Aedes aegypti or Aedes albopictus mosquito. Half the world's population lives in a dengue fever risk zone. There are an estimated 100 million symptomatic dengue fever cases each year, with 40,000 deaths reported. Brazil reports the highest annual dengue fever cases in Latin America. In 2022, Brazil recorded 2.36 million dengue fever cases, the highest number of cases ever recorded in the country. We designed a retrospective ecological study to evaluate the temporal trends and the association between weather events and dengue fever incidence …
Maternal, Infant, And Early Childhood Home Visiting And School Readiness In Alabama, Heather H. Johnson
Maternal, Infant, And Early Childhood Home Visiting And School Readiness In Alabama, Heather H. Johnson
All ETDs from UAB
This study examined the relationship between home visiting and school readiness in Alabama. Topics included a scoping review of the home visiting literature, statistical analyses of Alabama’s Teaching Strategies GOLD® (GOLD) data to determine if there were differences in performance among children who received home visiting compared to those who did not, and the development of a Key Driver Diagram (KDD) to inform improvement in home visiting practices that support school readiness. The scoping review of the literature indicated an absence of consistent definitions and measurement of the concept of school readiness. Through thematic analysis of the articles, contextual factors …
Navigating Missed Visits In Hiv Primary Care: Exploring Risk Factors Associated With Missed Visits, Jiaying Hao
Navigating Missed Visits In Hiv Primary Care: Exploring Risk Factors Associated With Missed Visits, Jiaying Hao
All ETDs from UAB
The HIV care continuum is a public health model that outlines the steps or stages people with HIV go through from diagnosis to achieving and maintaining viral suppression. Retention in care, a key component of the HIV care continuum, is critical in achieving good health outcomes for people with HIV (PWH) and preventing HIV transmission. Consistent HIV care is essential for the health of PWH as a part of retention in care. De-spite no standard measure for retention in care to PWH, the missed (no-show) vis-its/appointments is one of the most commonly used methods for evaluating retention in HIV care. …
The Genetic Epidemiology Of Complex Lung Diseases, Ava Claire Wilson
The Genetic Epidemiology Of Complex Lung Diseases, Ava Claire Wilson
All ETDs from UAB
This research utilizes precision medicine techniques to advance our understanding of Chronic Obstructive Pulmonary Disease (COPD) and Idiopathic Pulmonary Fibrosis (IPF) with the overall goal of improving the etiology of and identifying molecular targets and pathways in COPD and IPF to help improve patient outcomes. We aimed to 1) identify novel drug targets and uncover potential mechanisms by which pirfenidone and nintedanib attenuate fibrosis by performing an integrative ‘omics analysis of transcriptomics and proteomic responses to TGFb1-stimulated lung fibroblasts; 2) define a skeletal muscle fiber shift phenotype in both males and females with COPD and begin to disentangle underlying mechanisms …
Perceptionf Of Multipurpose Prevention Technologies Aimed At Hiv/Sti/Unintended Pregnancy Among African American Women In The Deep South, Kristina Wilbekin Walker
Perceptionf Of Multipurpose Prevention Technologies Aimed At Hiv/Sti/Unintended Pregnancy Among African American Women In The Deep South, Kristina Wilbekin Walker
All ETDs from UAB
Sexual and reproductive health (SRH) needs for women are not being met globally. In addition to efforts towards providing widespread access to currently available contraceptives and sexually transmitted infection (STI) treatment or prevention products, another focus is the development of multipurpose prevention technologies (MPTs). These MPTs are combination methods that prevent pregnancy, and protect against HIV and/or additional STIs. The objective of this dissertation research was to assess factors related to sexual and reproductive decision-making that may influence interest in MPTs and inform MPT implementation strategies for African and African American (AA) women. The first aim of this research, I …
Mediation Analysis Using Marginalized Zero-Inflated Poisson Model, Andrew Sims
Mediation Analysis Using Marginalized Zero-Inflated Poisson Model, Andrew Sims
All ETDs from UAB
Mediation analysis has become exponentially more popular over the last decade as researchers are interested in establishing mechanistic pathways for intervention. Standard statistical methods emphasize quantifying and testing whether a specific exposure impacts a particular health outcome. Mediation analysis addresses the question ‘How is the exposure causing the outcome?’ by examining the extent to which an intermediate variable, called a mediator, influences the relationship between an exposure and an outcome. While multiple mediation strategies exist, the counterfactual approach to mediation allows for mediation effects to be estimated directly with nonlinearities and interactions. The counterfactual approach allows for the effect of …
The Costly Performance Of Strength: An Exploration Of Mental Health Treatment Utilization Among Black Women In The Deep South, Amber N. Martin
The Costly Performance Of Strength: An Exploration Of Mental Health Treatment Utilization Among Black Women In The Deep South, Amber N. Martin
All ETDs from UAB
Introduction: Strength is indoctrinated into the cultural tapestry of Black women, dating back to slavery, and passed down through intergenerational socialization. The incessant need for Black women to be strong diminishes their psychological health leading to poorer quality of life. Further, historical injustices and unethical practices in mental healthcare continue to perpetuate the need for Black women to perform in strength. The performance of strength is one explanation for the grave mental health disparities among Black women offering an opportunity to better understand their mental health needs. This project aims to center Black women within the cultural contextualization of the …
Impact Of Malaria Rapid Diagnostic Test On The Receipt Of Antimalarials Among Children Aged 6-59 Months In Nigeria From 2010 To 2021, Sandra Chibuzor Olisakwe
Impact Of Malaria Rapid Diagnostic Test On The Receipt Of Antimalarials Among Children Aged 6-59 Months In Nigeria From 2010 To 2021, Sandra Chibuzor Olisakwe
All ETDs from UAB
Background: Nigeria has the highest malaria burden globally, and antimalarials have been commonly used to treat malaria without parasitological confirmation. In 2012, Nigeria implemented RDTs to reduce use of antimalarials for those without malaria and to increase the use of artemisinin-combination therapies (ACTs) for malaria treatment. In this study, we examined trends in antimalarial receipt among children aged 6-59 months during a 12-year period of increasing RDT availability. Methods: We conducted a cross-sectional analysis using nationally representative Nigeria Malaria Indicator Survey (NMIS) data from 2010 (before RDT implementation), 2015, and 2021. NMIS surveys used histidine-rich protein 2 (HRP2)- based RDTs …
Social Determinants Of Health And Blood Pressure Control In Black And White Us Adults, Oluwasegun Philip Akinyelure
Social Determinants Of Health And Blood Pressure Control In Black And White Us Adults, Oluwasegun Philip Akinyelure
All ETDs from UAB
Black adults in the US have 2 to 3 times higher rates of cardiovascular disease (CVD) mortality compared to White adults. Most of the excess CVD mortality in Black adults has been attributed to their higher prevalence of hypertension and uncontrolled blood pressure (BP). In October 2020, the US Surgeon General published a Call-to-Action to improve hypertension control and identified social determinants of health (SDOH) as a major contributor to Black:White disparities in hypertension control. Prior research has showed that SDOH are associated with excess hypertension risk among Black compared with White adults, but data on their association with BP …
Acute Placental Inflammation And Growth Outcomes In Preterm Infants, Emily Gunawan
Acute Placental Inflammation And Growth Outcomes In Preterm Infants, Emily Gunawan
All ETDs from UAB
Background. Acute placental inflammation (API) has been associated with various adverse outcomes in preterm infants. However, little is known about how API affects their body composition and growth outcomes. This study aims to examine the association between API and growth outcomes in preterm infants. Methods. We conducted a retrospective cohort study of mother-infant dyads born < 326/7 weeks of gestation with fat mass (FM) accretion measured using air displacement plethysmography at term-equivalent age. API severity including maternal inflammatory response (MIR) and fetal inflammatory response (FIR) was staged according to criteria by Society for Pediatric Pathology based on placental pathology reports. We examined the differences in characteristics of mother-infant dyads by API severity using ANOVA or the Kruskall-Wallis test. The association between API severity and growth outcomes was analyzed using linear regression models and adjusted for statistically significant confounders. Mediation analyses were used to study the direct and indirect association of API and growth outcomes via gestational age. Results. Among 375 mother-infant dyads analyzed, 104 (28%) dyads had MIR. FIR was found in 82% of dyads with MIR. Adjusted models indicated that API severity progression was positively associated with FM accretion. Gestational age partially (49%) iv mediated the association between API severity and FM z score (indirect effect: b=0.12, 95% CI: 0.05-0.19; direct effect: b=0.12, 95% CI: 0.01-0.25). Conclusions. API severity is associated with growth outcomes and helps to accurately predict body composition in preterm infants.
Social Vulnerability And Racial Disparities In Overall Survival Among Endometrial Cancer Patients, Alfonsus Adrian Hadikusumo Harsono
Social Vulnerability And Racial Disparities In Overall Survival Among Endometrial Cancer Patients, Alfonsus Adrian Hadikusumo Harsono
All ETDs from UAB
Introduction. Social vulnerability (SV) refers to potential negative effects on communities caused by external stresses on human health. The CDC/ATSDR Social Vulnerability Index (SVI) scores communities on 15 social indicators in 4 themes: (1) socioeconomic status (SES), (2) household composition and disability, (3) minority status and language, and (4) housing type and transportation. An overall score ranging from 0 (least vulnerable) to 1 (most vulnerable) is calculated to estimate vulnerability. We investigated whether SV as measured by the SVI can explain why black endometrial cancer (EC) patients survive less well than do white EC patients. Methods. We studied the survival …
Temporal Trends In Tularemia Incidence In The United States From 2010 To 2020. Are Age And Sex Associated With These Changing Trends?, Carla V. Brooks
Temporal Trends In Tularemia Incidence In The United States From 2010 To 2020. Are Age And Sex Associated With These Changing Trends?, Carla V. Brooks
All ETDs from UAB
Background: Tularemia or Rabbit Fever was discovered in 1911 in a plague-like outbreak among rodents in Tulare County, California. Tularemia in the US has expanded from rural to more metropolitan areas, which may be potentially correlated with the escalating exposure of humans to animal vectors. There has not been a recent study evaluating trends in Tularemia, especially one that has evaluated if the trends in Tularemia over time differ by demographic characteristics. Methods: This is an ecological study to evaluate the temporal trends and if trends Tularemia incidence over time differs by age and sex in the United States from …
Understanding How Multi-Level Factors Influence Cancer Clinical Trial Enrollment Decisions By Patients Living In Higher Disadvantaged Areas, Nicole Caston
All ETDs from UAB
Cancer clinical trials offer current patients with cancer new treatment and novel interventions to treat their cancer, while advancing the care of future patients. Clinical trials test new drugs against the standard of care to determine drug efficacy and safety. There are many groups of patients who are either unrepresented or underrepresented in cancer clinical trials and there is a plethora of reasons they are not represented. One underrepresented population of interest is patients with cancer who live in highly disadvantaged neighborhoods. Previous research found that when compared to patients who live in areas of lower disadvantage, patients living in …
Socioeconomic Challenges Of Long Covid, Justin Catt
Socioeconomic Challenges Of Long Covid, Justin Catt
All ETDs from UAB
Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection or PASC, is a condition resulting from a SARS-CoV-2 infection characterized by continuing or novel symptoms across multiple organ systems occurring at least four weeks after infection. Symptoms of Long COVID can include cognitive impairment, memory loss, and fatigue. Although associations between COVID-19 and social determinants of health have been studied, noting that disadvantaged socioeconomic or racial groups have higher incidence and mortality rates from COVID-19, the associations between Long COVID and social determinants of health have not been robustly examined. Using data from the Household Pulse Survey in Summer …
Antimicrobial Resistance In Type Ii Diabetic Patients In Southeastern U.S., Onyebuchi Angela Elegede
Antimicrobial Resistance In Type Ii Diabetic Patients In Southeastern U.S., Onyebuchi Angela Elegede
All ETDs from UAB
Background: In the Southern and Appalachian regions of the United States, antibiotic prescription rates surpass the national average, coinciding with a higher prevalence of Type II diabetes (DM2). Although international research has previously described the correlation between DM2 and increased risk of antimicrobial-resistant (AMR) infections, comprehensive studies on this relationship are lacking in the U.S. The objective of this study was to investigate the association between AMR infections and DM2 and examine the association in two DM2 positive racial groups. This study also examined the differences in the prevalence of clindamycin resistance of methicillinresistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus …
Parenting Through A Pandemic: A Mixed Methods Analysis Of Covid-19’S Impact On Stress, Coping, Resiliency, And Mental Health Among University Student-Parents, Jordin Ann Lane
All ETDs from UAB
The COVID-19 pandemic has taken a toll on the mental health of university students and continues to have a profound impact to this day. The transition from in-person traditional courses to online courses and campus closures, coupled with feelings of isolation, fear of contracting COVID-19, and uncertainty of the future has further intensified the mental health of college students. The effects of federal and state regulations, such as stay-at-home orders, influenced the mental health and general well-being of many Americans, specifically those who take on a dual role as a student and a parent. Unfortunately, literature pertaining to the effects …
Identifying The Factors Influencing Hiv Testing And Safe Sex Practices: An Ecological Approach, Shekwonya Evelyn Samuel
Identifying The Factors Influencing Hiv Testing And Safe Sex Practices: An Ecological Approach, Shekwonya Evelyn Samuel
All ETDs from UAB
Introduction: HIV (Human Immunodeficiency Virus) is a sexually transmitted infection (STI) that is still a major health issue in the United States and the world. Emerging adults are more likely to engage in risky sexual behaviors such as multiple sexual partners and unprotected sex. HIV testing contributes to ending the HIV epidemic by identifying at-risk individuals and promoting early diagnosis.Methods: Secondary data analyses of the City Health II dataset were conducted to 1) identify the association between HIV testing and risky sexual behaviors among Black/African American emerging adults ages 18-25 years living in Birmingham metro area, 2) use social network …
Social Vulnerability And Trust Associated With African American Secondary Syphilis Cases Reported In Alabama, United States, 2020-2022, Givanta Tribit
Social Vulnerability And Trust Associated With African American Secondary Syphilis Cases Reported In Alabama, United States, 2020-2022, Givanta Tribit
All ETDs from UAB
Introduction: Syphilis is a sexually transmitted infection (STI) that can cause serious health problems, including neurological disorders, blindness, and fetal abnormalities. Routine STI screenings can help prevent its spread. Despite effective treatments, syphilis cases have risen sharply in the last decade, particularly among marginalized communities. Understanding the ecological and contextual factors contributing to syphilis incidence could inform prevention efforts and improve healthcare outcomes for all. Methods: Retrospective secondary data analyses, at the county level, from 2020 to 2022, were conducted to assess for mean differences among social vulnerability index (SVI) scores, SVI scores by four primary categories, Black Belt regional …
Neighborhood Disadvantage, Sleep Quality, And Shift Work: The Reasons For Geographic And Racial Differences In Stroke (Regards) Study, Rebecca Williams
Neighborhood Disadvantage, Sleep Quality, And Shift Work: The Reasons For Geographic And Racial Differences In Stroke (Regards) Study, Rebecca Williams
All ETDs from UAB
The first study used data (n=14,609) from the REasons for Geographic and Racial Differences in Stroke (REGARDS) to test the associations among Area Deprivation Index (ADI) and self-reported total sleep time (TST), sleep efficiency (SE), and number of restless nights within the last week. The second study (n=12,496) tested the associations among ADI, shift work status, and restlessness.Regression models were fit to examine associations between ADI and SE or TST or restlessness, as well as assess the relation between ADI and SE in clinically meaningful categories. Moderation analyses indicated whether sex or race impact the association between ADI and sleep. …
Access To The Kidney Transplant Waitlist For People Living With Hiv, Brittany A. Shelton
Access To The Kidney Transplant Waitlist For People Living With Hiv, Brittany A. Shelton
All ETDs from UAB
People living with HIV (PLWH) have experienced substantial increases in life expectancy, largely attributable to improvements in care such as antiretroviral therapy. As a result, there has been a concurrent increase in the development of aging-related comorbidities such as end-stage organ disease. One such comorbidity is kidney disease. Concerningly, PLWH are at disproportionately higher risk of chronic kidney disease and end-stage kidney disease (ESKD) as compared to HIV-negative counterparts. Kidney transplantation is the ideal therapy for ESKD as it is both cost-effective and provides a significant survival benefit and yet, despite excellent transplant outcomes among PLWH, access to transplantation among …
Racial Differences In The Association Of Insulin Resistance With Risk Of Incident Heart Failure In Participants Of Regards, Nirav Patel
All ETDs from UAB
Background: Insulin resistance is linked to the development of heart failure (HF). However, there is limited understanding of the racial differences in the association of insulin resistance with the risk of incident HF among individuals without diabetes. Objectives: In a US national cohort of Black and White participants, we sought to evaluate: 1) the relationship between insulin resistance with incident HF participants, and 2) whether there are racial differences in the association of insulin resistance with HF. Methods: We examined >16,000 participants without HF and diabetes at baseline from the REGARDS cohort. Cox regression modeling was used to assess the …
Regional Variations In The Incidence Of Brain Glioma In Adults In Alabama, Mina Lobbous
Regional Variations In The Incidence Of Brain Glioma In Adults In Alabama, Mina Lobbous
All ETDs from UAB
Purpose: Gliomas are the most common primary brain tumor in adults in the US with an annual age-adjusted incidence rate of 4.67 to 5.73 per 100,000 persons. Exposure to ioniz-ing radiation is the only established risk factor for non-hereditary glioma risk. There are several sources of carcinogenic contaminants in northeast Alabama and western Georgia with the Coosa River serving as the region’s primary water source. In this study, we aimed to examine the incidence rate of glioma in northeast Alabama compared to the rest of the state as well as the association of possible environmental exposure on disease risk and …
The Association Between Paraquat Exposure And Parkinson's Disease Mortality: A County-Level Ecological Study In The United States, Alexander Kozuch
The Association Between Paraquat Exposure And Parkinson's Disease Mortality: A County-Level Ecological Study In The United States, Alexander Kozuch
All ETDs from UAB
Objectives: The current study reports the results of an ecological study regarding the association between PQ exposure and Parkinson’s disease mortality in the United States. Methods: The outcome of interest for this study was mortality due to Parkinson’s disease, obtained from CDC Wonder. The exposure of interest was PQ exposure at the county level which was obtained from the United States Geological Survey (USGS). Statistical analysis was done using the mortality data, grouped into ten-year age groups, and focused on data from 2015-2019 to account for the lag time between initial Paraquat exposure and Parkinson’s Disease mortality. A Negative Binomial …
Intracerebral Hemorrhage Hospitalizations And Outcomes: Comparisons Between Institutional And National Data, Zhuobin Huang
Intracerebral Hemorrhage Hospitalizations And Outcomes: Comparisons Between Institutional And National Data, Zhuobin Huang
All ETDs from UAB
Intracerebral hemorrhage (ICH) is associated with a high risk of in-hospital mortality therefore we decided to define the effect of procedures and other risk factors on in-hospital mortality among different regions in the US. South and UAB Hospital. We used 2 datasets, the University of Alabama at Birmingham Hospital data and the National Inpatient Sample (NIS). We included 425 patients with a diagnosis of intracerebral hemorrhage over 18 years of age from the UAB Hospital stroke registry between 2016 to 2019; in NIS between 2016 to 2018, 68525 patients age 18 or above met inclusion criteria selected by International Classification …
Socioeconomic Status, Hbb, And Ttr Variants, And Cardiorenal Outcomes: The Regards Study, Onika E. Abrams
Socioeconomic Status, Hbb, And Ttr Variants, And Cardiorenal Outcomes: The Regards Study, Onika E. Abrams
All ETDs from UAB
Blacks are disproportionately affected by heart failure (HF) and end-stage renal disease (ESRD). While poorer health outcomes in Blacks have been associated with social determinants of health, there are some biological differences worth noting, namely genetic risk variants for both TTR and HBB. These genetic risk variants are known to confer additional risk in the development of heart failure and end-stage renal disease, respectively. While we understand these genetic variants aren’t fully penetrant, and genetics and are not deterministic, we aimed to examine additional factors and mechanisms responsible for the increased risk in HF and ESRD in Blacks. Neighborhood socioeconomic …
Association Between Regional Covid-19 Vaccine Hesitancy And Reported Positive Covid-19 Cases In The Southern United States, Orielle Caudle
Association Between Regional Covid-19 Vaccine Hesitancy And Reported Positive Covid-19 Cases In The Southern United States, Orielle Caudle
All ETDs from UAB
The use of vaccinations has been shown to be beneficial in pandemics in the past, and in some cases, it has led to elimination of a particular disease (i.e. polio). The COVID-19 vaccination can also serve the same purpose, however, vaccine hesitancy within specific regions of the country may prevent and/or dilute the effectiveness of the vaccine. Vaccine hesitancy can be defined as a delay in acceptance, or refusal despite the availability of vaccine services. Southern regions have consistently had the lower vaccination rates compared to its other regional counterparts, even as the pandemic progressed and death rates increased over …
Spike-And-Slab Additive Models And Scalable Algorithms For High Dimensional Data Analysis, Boyi Guo
Spike-And-Slab Additive Models And Scalable Algorithms For High Dimensional Data Analysis, Boyi Guo
All ETDs from UAB
There are proposals that extend classical additive models (AMs) to accommodate high-dimensional data (p >> n) using group sparse regularization. However, the sparse regularization may induce excess shrinkage when estimating smooth functions, damaging predictive performance. Moreover, most of these AMs consider an “all-in-allout” approach for functional selection, rendering them difficult to answer if nonlinear effects are necessary. While some Bayesian models can address these shortcomings, model fitting can create a new challenge, scalability. In this dissertation, we propose Bayesian hierarchical additive models to address the previous shortcomings: we consider the smoothing penalty for proper shrinkage of curve interpolation via reparameterization. A …