Public Health Commons^™

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

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

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

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

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

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

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

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

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

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 …

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

All ETDs from UAB

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

All ETDs from UAB

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

All ETDs from UAB

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

All ETDs from UAB

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

All ETDs from UAB

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

All ETDs from UAB

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

All ETDs from UAB

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 …

An Axisymmetric Finite Element Model To Study The Earplug Contribution To The Bone Conduction Occlusion Effect, Martin K. Brummund, Franck Sgard, Yvan Petit, Frédéric Laville, Hugues Nélisse

Études primaires

An axisymmetric linear elasto-acoustic finite element (FE) model of an occluded human external ear is proposed to simulate the bone conduction occlusion effect (OE). The model consists of a cylindrical ear canal cavity surrounded by layers of biological tissues (skin, cartilage and bone) in which an earplug is inserted. Geometrical and material properties are taken from the literature. OEs are predicted for foam and silicone earplug FE-models using COMSOL Multiphysics (COMSOL®, Sweden). The FE-model is shown to predict the experimental OE measured in two healthy human reference groups wearing foam or silicone earplugs, satisfactorily. Deviations between model and experiment are …

Identification Of Intrinsic And Reflexive Contributions To Low-Back Stiffness: Medium-Term Reliability And Construct Validity, Christian Lariviere, Daniel Ludvig, Robert Kearney, Hakim Mecheri, Jean-Maxime Caron, Richard Preuss

Études primaires

This study aimed at testing the reliability and construct validity of a trunk perturbation protocol (TPP) that estimates the intrinsic and reflexive contributions to low-back stiffness. The TPP consists of a series of pseudorandom position-controlled trunk perturbations in an apparatus measuring forces and displacements at the harness surrounding the thorax. Intrinsic and reflexive contributions to low-back stiffness were estimated using a system identification procedure, leading to 12 parameters. Study 1 methods (reliability): 30 subjects performed five 75- s trials, on each of two separate days (eight weeks apart). Reliability was assessed using the generalizability theory, which allowed computing indexes of …

Predictors Of Obesity Among Nigerian Immigrants In The United States, Olawunmi Obisesan

Walden Dissertations and Doctoral Studies

Obesity has been identified as a significant risk factor for chronic diseases, contributing to health disparities in minority and vulnerable populations. Though research has identified an increased risk for obesity in the Hispanic immigrant population, there is little or no research on the heterogeneity of obesity predictors in specific immigrant populations in the United States. This study examined the predictors of obesity in the Nigerian immigrant population in the United States. Guided by the social ecological model and the segmented assimilation theory, this cross-sectional study collected primary data from 205 Nigerian immigrants in the United States using the CDC's Behavioral …

Third-Degree Family Health History And Perception Of Disease Risk, Liana Carrasco Romero

Walden Dissertations and Doctoral Studies

Chronic diseases are a significant cause of illness and mortality in the United States. Hereditary predisposition to chronic diseases is a useful indicator for identifying people at risk for disease development. An ideal tool for determining this predisposition is the CDC, NIH, and AAFP recommended third-degree family health history (FHH). The aim of this quantitative, cross-sectional study, based on the theoretical frameworks of social constructivism and the health belief model, was to assess the possible influence between the completed third-degree FHH and the participant's perception of disease risk. Two-hundred seventy-three participants were recruited from health care facilities and from the …

Estimation Of Bias With The Single-Zone Assumption In Measurement Of Residential Air Exchange Using The Perfluorocarbon Tracer Gas Method, K Van Ryswyk, L. Wallace, D. Fugler, M. Macneill, M. E. Heroux, M. D. Gibson, J. R. Guernsey, W. Kindzierski, A. J. Wheeler

Research outputs 2014 to 2021

Residential air exchange rates (AERs) are vital in understanding the temporal and spatial drivers of indoor air quality (IAQ). Several methods to quantify AERs have been used in IAQ research, often with the assumption that the home is a single, well‐mixed air zone. Since 2005, Health Canada has conducted IAQ studies across Canada in which AERs were measured using the perfluorocarbon tracer (PFT) gas method. Emitters and detectors of a single PFT gas were placed on the main floor to estimate a single‐zone AER (AER1z). In three of these studies, a second set of emitters and detectors were deployed in …

Minority Stress, Depression, Relationship Quality, And Alcohol Use: Associations With Overweight And Obesity Among Partnered Young Adult Lesbians, Tyler B. Mason, Robin J. Lewis

Psychology Faculty Publications

Purpose: Although lesbian women are more likely to be obese compared to heterosexual women, relatively little research has examined correlates of overweight and obesity among lesbians. The purpose of this study was to examine the association of minority stress and depression, relationship quality, and alcohol-use variables to overweight and obesity among lesbians in relationships.

Method: Self-identified lesbians (n = 737) in current relationships completed measures of demographics, minority stress, depressive symptoms, relationship variables, and alcohol use.

Results: Overweight and obesity were associated with more public identification as a lesbian, more depressive symptoms, increased heavy drinking, longer relationship length, and lower …

Overview Of Australian Indigenous Health Status, 2014, Jane Burns, Samantha Burrow, Neil Drew, Michelle Elwell, Caitlin Gray, Millie Harford-Mills, Joanne Hoareau, Renee Lynch, Andrea Macrae, Trish O'Hara, Christine Potter, Kathy Ride, Avinna Trzesinski

Research outputs 2014 to 2021

The main purpose of the Overview is to provide a comprehensive summary of the most recent indicators of the health and current health status of Australia’s Aboriginal and Torres Strait Islander peoples. It has been prepared by the Australian Indigenous HealthInfoNet as a part of our contribution to ‘closing the gap’ in health between Aboriginal and Torres Strait Islander people and other Australians by making relevant, high quality knowledge and information easily accessible to policy makers, health service providers, other health professionals including Health workers, program managers, clinicians, researchers, students and the general community.

The initial sections of this Overview …

Documenting Perceived Effectiveness Of Community-Based Health Promotion Coalitions: A Grounded Theory Approach, Alyssa Brooke Mayer

USF Tampa Graduate Theses and Dissertations

Introduction: Community coalitions with public health-related missions are formal, semi-permanent, action-oriented partnerships comprised of community members, representatives of government agencies, policymakers, and academic partners. Despite their potential to promote sustainable change, coalitions have had mixed success in effecting long-term improvements in community health. There is a need to assist them in developing strategies for improving and sustaining their functionality. The purpose of this study was to improve understanding of the elements of coalition success and sustainability that are vital to health-related community-based participatory research.

Methods: Although the literature describes coalition functions for effecting sustainable programs and policies, most research reports …

Overview Of Aboriginal And Torres Strait Islander Health Status 2015, Australian Indigenous Healthinfonet

Research outputs 2014 to 2021

The main purpose of the Overview is to provide a comprehensive summary of the most recent indicators of the health and current health status of Australia’s Aboriginal and Torres Strait Islanders people. It has been prepared by Australian Indigenous HealthInfoNet staff as part of our contribution to supporting those who work in the Aboriginal and Torres Strait Islander health sector. The Overview is a key element of the HealthInfoNet commitment to authentic and engaged knowledge development and exchange. The initial sections of this Overview provide information about the context of Aboriginal and Torres Strait Islander health, population, and various measures …

Women’S Use Of And Decision‐Making Regarding Geo‐Social Networking Applications To Arrange Sexual Experiences, Shireen Mary Noble

USF Tampa Graduate Theses and Dissertations

The purpose of this thesis was to learn more about geo-social networking applications and how they are used by women to meet sexual partners. Currently, there are no known studies that have looked at heterosexually-oriented geo-social networking applications or at the way women have used these apps for heterosexual sexual encounters. This thesis attempts to begin to bridge this gap in the literature.

For the first study, apps were selected based on their appearance in popular media articles about dating applications. Results generally related to online safety concerns, while occasional features were related to sexual safety concerns. Communication options were …

Exploring The Association Between Network, Cognitive, Structural Social Capital And The Risk Of Clinical Depression In Taiwan, Yun-Hsuan Wu

Theses and Dissertations

Depression is the one of most common mental health conditions in Taiwan. Although evidence suggests that social capital is associated with depression, few studies have comprehensively explored the influence of social capital on depression. Also evidence in Taiwan is limited in comparison to other Western countries. Data from the 1997 Taiwan Social Change Survey (n=2,598), which is the only dataset that contains the best available information to measure and compare all three dimensions of social capital (network, cognitive, and structural social capital), were used to examine the association between three dimensions of neighborhood- and individual-level social capital and depression among …

Environmental Exposures And Childhood Pulmonary Function, Pallavi Prakash Balte

Theses and Dissertations

Fetal origins of adult disease hypothesis states that adverse influences early in developmental period and particularly during intrauterine life can result in permanent changes in physiology which may lead to increased disease risk of chronic diseases in adulthood. Both fetal and adolescent period are critical time periods for development of lungs. Any adverse environmental exposures during these critical periods of lung growth is a form of programming which can have long term effects on pulmonary function. The purpose of this dissertation was to examine the association between different environmental exposures and pulmonary function in children and late adolescents. The first …

Statewide Scale-Up Of Group Prenatal Care In South Carolina, Kristin M. Van De Griend

Theses and Dissertations

Background: Poor birth outcomes and racial disparities in birth outcomes in South Carolina are widely recognized problems. To improve maternal and child health outcomes, especially among vulnerable groups, universal access to timely, appropriate, and effective care should remain a priority through increased availability and accessibility. An interagency collaborative in South Carolina expanded CenteringPregnancy (CP) from two to five medical practices throughout the state. CenteringPregnancy is associated with improved birth outcomes and reduced rates of racial disparities in preterm birth throughout the United States. Important questions in the literature remain about strategies and determinants of scaling up sexual and reproductive …