Public Health Commons^™

Prophylactic Antimalarial Intermittent Preventive Therapy In Pregnancy And Birth Weight In Togo, Epiphane Awokou

Walden Dissertations and Doctoral Studies

In Togo, prophylactic antimalarial intermittent preventive therapy in pregnancy (IPTp) is provided to disrupt suboptimal pathways leading to the issue of low birth weight. However, there is a lack of nationally representative data on the determinants of this adverse birth outcome. The purpose of this quantitative cross-sectional study was to determine pregnancy-related determinants of low birth weight through a nationally representative dataset. Bronfenbrenner’s ecological systems model guided this study to explore potential associations between the covariates IPTp, utilization of long-lasting insecticidal bed nets, age of pregnant women, socioeconomic status of pregnant women, and gravidity type of pregnant women and the …

Typhoid Fever Among Low-Income Women Living In Gujranwala, Pakistan., Tehmina S. Khan

Walden Dissertations and Doctoral Studies

Approximately 21 million individuals suffer from typhoid fever (TF) globally, and most outbreaks occur in Southeast Asia. The incidence of TF is high in Pakistan, particularly in low socioeconomic areas, and a new drug-resistant strain makes it difficult to control the spread of TF. There is a pressing need for up-to-date and accurate data regarding the attitudes, beliefs, and habits leading to the spread of TF infection among individuals living in low socioeconomic areas of Pakistan. This qualitative, phenomenological study was grounded in the health belief model and explored factors that influence the spread of TF among women of childbearing …

The Association Of Suicidality With Video Gaming And Physical Inactivity Among U.S. Adolescents, Mary Colleen Cyrus

Walden Dissertations and Doctoral Studies

Suicide represents a leading cause of death in U.S. young people, and the rate is increasing. Although young people are spending more time each day playing video or computer games, there is limited research on the association, if any, between playing video games and suicidality. The purpose of this study was to identify whether there is a statistically significant association between video gaming, physical inactivity, and suicidality (suicidal ideation, planning, and attempts). Age, race, gender, and being bullied electronically and in school were assessed as potential confounding variables. The interpersonal theory of suicidal behavior and the social-ecological theory served as …

Alternative Diet Practices As Predictors For Vaccine Confidence, Nancy Dolin

Walden Dissertations and Doctoral Studies

Perceived risks and side effects have left some with a lack of confidence in the safety and efficacy of vaccines. This may lead to not adhering to the recommended vaccination schedule and result in outbreaks that have the potential to harm those who are unable to get vaccinated due to age or infirmity. It is vital to seek and address the characteristics that may predict one’s confidence in vaccines. The aim of this study was to identify whether an individual’s alternative diet behavior may be able to predict their confidence in the measles, mumps, and rubella (MMR) vaccine. The theoretical …

The Outcome Of Stroke Education And Management On Cerebrovascular Accident Patients In Bermuda, Antoinette Simone Dyer

Walden Dissertations and Doctoral Studies

AbstractIncidence of cardiovascular accident (CVA), also referred to as a stroke, has increased in Bermuda. Understanding key contributing factors is necessary to reduce incidences that are associated with this disease process. This dissertation examined the outcome of stroke education and management on CVA patients in Bermuda. The health belief model, incorporating a reflection of the public health framework, guided the analysis of a quantitative dataset obtained through Bermuda Hospitals Board’s Neurology Department. A cross-sectional study design was used to sample 253 stroke patients over a 2-year period (2019 -2021). The Wilcox test was employed to compare two groups – stroke …

Length Of Stay In A Homeless Shelter And Mitigating Homelessness, Uwemedimo S. Etteyit

Walden Dissertations and Doctoral Studies

AbstractHomelessness is a major public health issue in the United States. Every night, thousands of people have no residence to call their own. Most homeless persons turn to homeless shelters for help. Despite the homeless shelters, the problem of homelessness persists. This study examined the concept that the length of time spent at a homeless shelter is related to the homeless persons mitigating their homelessness through home placement, jobs, and healthcare access. Homelessness was examined using the socioecological model with its attendant levels of influence. On the intrapersonal level, socioeconomic status, education, old age, veteran status, and disability were factors. …

Assessing Violence And Mental Health With The 2019 Nevada Youth Risk Behavioral Survey, Samantha Graham

Walden Dissertations and Doctoral Studies

The effects from childhood trauma can interfere in all aspects of a child’s life, including their education. School delivery systems need to be trained to identify these risks and how to reduce further risks of re-traumatization by applying trauma-informed practices. This study addressed the impact of adverse childhood experiences (ACEs) on mental health and behavioral issues. The study was guided by Bandura’s social cognitive theory and the socioecological model. The correlation between ACEs and mental health as well as ACEs and physical violence were examined based on data from the 2019 Nevada Youth Risk Behavioral Survey, which was a high …

The Impact Of Staff Sexual Misconduct On U.S. Federal Prison Inmates’ Mental And Physical Health, Wanwisa Grover

Walden Dissertations and Doctoral Studies

Prison staff sexual misconduct is an ongoing issue in the United States, but little is known about how inmates’ perceptions of staff sexual misconduct influence their mental and physical health. The purpose of this quantitative research study was to examine the relationship between staff sexual misconduct with federal prison inmates and prisoner mental health and rates of injury, and why inmates are not reporting sexual misconduct encounters. Ecological theory provided the theoretical foundation. The three research questions were designed to examine the relationships between nonconsensual sexual misconduct of prison inmates with prison staff and (a) serious mental health illnesses and …

Health-Related Quality Of Life For Veterans Transitioned Into Civilian Life, Vicki Ann Guerra

Walden Dissertations and Doctoral Studies

Texas veterans transitioning to civilian life have experienced health issues after discharge. There are processes to follow before seeking treatment or diagnosis for any health issue prior to military discharge. Given the gaps in the literature on veteran health, quality of life and transition to civilian life, scholars lack understanding of the transitional events that take place. Veteran health issues are impacted by medical appointment wait-times, day to day life events, and this can lead to decreased quality of life. The purpose of this mixed-methods study (N=36) was to evaluate veterans’ health related quality of life who had transitioned from …

Using Social Perspectives On Vaccination To Build Public Trust In Pro-Vaccine Communication, Lindsay Hale

Walden Dissertations and Doctoral Studies

United States public health guidelines for mandating vaccination of school age children for preventable diseases is increasingly ineffective. Little is known, however, about what sociocultural factors influence parents’ and legal guardians’ decisions to adhere to, hesitate against, or refuse to abide by immunization public health guidelines. The purpose of this qualitative study was to discover and better understand sociocultural factors that contribute to or detract from parents and legal guardians’ adherence to recommended vaccination schedules. The theoretical framework for this study was Coleman’s Rational Choice Theory. Research questions involved sociocultural factors and reference groups that influence parents and legal guardians’ …

Marijuana Legalization And Depression Effects On Marijuana Use In African American Late Adolescents, Anthony Olusegun Iroko

Walden Dissertations and Doctoral Studies

State medical marijuana legalization (MML) may contribute to increased cannabis use among older adolescents, especially African American youth and adolescents with depression. This quantitative cross-sectional correlational study, which utilized Smart’s availability-proneness theory of drug use as a guiding framework, had a two-fold purpose: to determine if state MML status and self-reported depression were significantly related to past-month marijuana use and to assess if state MML status significantly moderated between depression and past-month marijuana use. The study utilized data from 1,391 African American late adolescents (aged 16-20) who participated in the 2018 National Survey on Drug Use and Health. Binary logistic …

Peripherally Restricted Delivery System Provides Insights On The Role Of Cns In Precipitating Opioid-Induced Constipation, Dengpan Liang

University of the Pacific Theses and Dissertations

A serious opioid crisis is affecting public health and economics, eroding people’s quality of life. 80% of patients who receive opioids suffer from adverse effects such as Opioid-induced constipation (OIC). However, there is no efficient medicine for these adverse effects. Notably, mainstream theory supports that analgesia effects are mainly controlled by CNS while OIC is predominately controlled by peripheral. In addition, the sites of action of opioid was based on the assumption that mu-opioid receptor antagonists (PAMORAs), did not cross the blood-brain barrier (BBB). Unfortunately, the BBB crossing of PAMORAs mislead the understanding of the role of the central nervous …

Screen Media Use Among Children And Adolescents – Applications Of Supervised And Unsupervised Machine Learning And Sentiment Analysis, Yifan Zhang

Graduate Theses, Dissertations, and Problem Reports (ETD)

Screen media has become increasingly pervasive in our everyday lives and has profoundly changed the way people communicate and interact with each other. However, we are still unclear about the long-term influence of screen media use on our physical health, mental health, and social wellbeing. Children and adolescents are in an important stage of brain development and are susceptible to the environmental influence that screen media possess. This dissertation pursued three aims to address research gaps related to screen media use among children and adolescents: 1) identify topics and knowledge gaps in screen media use research among children and adolescents …

Examining The Spatial Relationship Between Maternal Morbidity, Access To Health Care, And Community Characteristics In West Virginia, Sarah E. Woolard

Graduate Theses, Dissertations, and Problem Reports (ETD)

Maternal-related morbidity rates in the United States have risen almost three fold since the early 1990’s. Issues related to rurality, socioeconomic disparities, and pre-existing health conditions increase the risk of poor pregnancy outcomes and introduce barriers to accessing advanced maternal health care. West Virginia (WV) has higher maternal morbidity rates than many other states in the United States (US), and is considered to be driven by all 55 counties being classified as Appalachian, possessing the highest prenatal smoking rate in the US, and having disparities in access to health care. Despite this, no previous studies have evaluated maternal morbidity in …

Factors Associated With Service Utilization In Injured Workers In West Virginia, Brandy Brown

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Minimal research has been conducted on healthcare utilization among injured workers residing in rural areas. These workers are often at high risk for work-related injury due to the industries in which they work and commonly experience barriers to accessing healthcare. The first study in this dissertation series explored general characteristics of injured workers receiving care at occupational medicine clinics in West Virginia (WV). The second and third studies explored the moderating effects of rurality, pain medication, and psychiatric medication on sociodemographic and health status factors and number of medical encounters.

Methods: Each study used a cross-sectional design with data …

Performance Of Peltier Cooled Technology During Preconcentration Of Volatile Organic Compounds Analyzed By Gas Chromatography-Mass Spectrometry (Gc-Ms) Using Niosh Manual Of Analytical Methods (Nmam) 3900, Elizabeth Ann Fernandez

Graduate Theses, Dissertations, and Problem Reports (ETD)

Using evacuated canisters for whole-air sampling allows for sampling without specific knowledge of the environment and potential analytes. Evacuated canisters are able to tolerate concentrations ranging from parts per trillion (PPT) to parts per million (PPM). The U.S. Environmental Protection Agency (EPA) has used evacuated canisters for years to sample volatile organic compounds (VOCs) from ambient air using their method TO-15 (LeBouf, et al., 2019). The GC-MS system used for the development of NMAM 3900 used liquid nitrogen to cool sorbent traps in the preconcentrator. Liquid nitrogen allows for cooling of specified points below ambient temperature. An alternative to liquid …

Communicating Clinic Visit Information To Family Caregivers, Reed Wr Bratches

Dartmouth College Ph.D Dissertations

Statement of the Problem: Information from clinic visits is critical to family caregivers, who are the family members or friends who provide at-home care for their loved ones. However, patient’s clinic visits are infrequently attended by caregivers. While methods exist to communicate information from visits to patients, little is known about the methods used to communicate with caregivers, or their effects on caregiver outcomes. I address this gap in this dissertation through three studies.

Methods: A systematic review was used synthesize the methods used to communicate information to family caregivers and their impact on caregivers. A national survey of family …

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

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

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

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

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

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 …

Prolonged Prone Positioning For Covid-19-Induced Acute Respiratory Distress Syndrome: A Randomized Pilot Study, David Brian Page

All ETDs from UAB

ationale: Prone positioning is one of the few interventions shown in a robust, randomized, controlled clinical trial to reduce mortality in severe ARDS. Ideal duration of prone positioning is unknown. A 16-hour prone positioning period has been studied and is considered standard, although longer duration may be beneficial. Objectives: Determine if a prolonged prone positioning strategy for patients with COVID-19-induced ARDS is feasible and safe. Methods: We performed a pilot, randomized, parallel-arm feasibility study in patients with COVID-19-induced ARDS. Patients were randomized to either a prolonged 24-hour or a traditional 16-hour prone positioning strategy. Measurements & Main Results: 52 patients …

Photothermal Desorption Of Volatile Organic Compounds From Buckypaper Sorbents, For Occupational Exposure Assessment, Jacob S. Shedd

All ETDs from UAB

Volatile organic compounds (VOCs) are a common source of occupational exposures. To prevent adverse health effects in employees, industrial hygienists must regularly conduct occupational air sampling to ensure exposures remain below regulatory limits. As such, the need for sensitive and reliable exposure assessment methodologies becomes apparent. Currently, diffusive sampling is popular and well-established exposure assessment method amongst professionals. However, its reliance on diffusion-driven mass uptake and chemical extraction, results in limited analytical sensitivity. In response to this, a pre-analytical technology, known as photothermal desorption (PTD), has been in development over the past decade. PTD uses pulses of high-energy light to …

Filtration And Adsorption Performance Of Activated Carbon Fiber: Applications For Respiratory Protection, Margaret C. Summers

All ETDs from UAB

Activated Carbon Fiber (ACF) is an adsorbent material that can be used to re-move volatile organic compounds (VOCs) from the air. Unlike granular adsorbents that are currently used in organic vapor respirators, ACF is a self-supporting fiber structure that can be tailored into non-woven forms and can potentially be used to support particu-late filtration. While ACF-containing respirators first appear in patent literature in the 1980s, the use of ACF in respiratory protection has not been widely considered in the PPE market in the intervening years. To develop the concept of an ACF-containing N95 that offers particulate filtration in addition to …

Non-Mean Ambulatory Blood Pressure Monitoring Parameters And Left Ventricular Hypertrophy: Analysis Of Pooled Population- And Community-Based Studies, Swati Sakhuja

All ETDs from UAB

High mean blood pressure (BP) on ambulatory BP monitoring (ABPM) is a strong risk factor for left ventricular hypertrophy (LVH), an early manifestation of hypertension-related cardiovascular disease (CVD). Typically, 48-72 systolic and diastolic BP (SBP and DBP) readings are obtained on a 24-hour ABPM recording. The large number of readings from ABPM allows for the estimation of parameters beyond mean BP that capture level and fluctuation in BP over 24-hours, which may be useful for identifying individuals at high risk for CVD. The measures of BP level other than mean BP obtained from ABPM recording include BP load (percentage of …

Power And Sample Size Calculations For Linear Mixed Models Of Longitudinal Data Using The Kenward-Roger Adjusted Wald Test, Tarrant Oliver Mcpherson

All ETDs from UAB

The linear mixed model has become a popular technique for the analysis of longitudinal data, but Wald test statistics of fixed effects for these models frequently lack well defined distributions. A common approach to this problem uses the Kenward-Roger adjustment, which attempts to approximate the distribution of the Wald statistic by matching its moments obtained via Taylor expansion to those of an F distribution. However, this approach only matches moments obtained under the null hypothesis of no effect and cannot currently be used to approximate the distribution of the test statistic under some alternative hypothesis. This limitation prevents a straightforward …

Parent And Healthcare Provider Beliefs About Chlamydia Adolescent Vaccine, Alison P. Footman

All ETDs from UAB

Introduction: Chlamydia is the most common bacterial sexually transmitted infection (STI) worldwide and it disproportionally affects young people and those living in the Southern United States. If left untreated chlamydia infections can lead to complications such as infertility and pelvic inflammatory disease. Currently, chlamydia vaccines are being development. A successful chlamydia immunization program would require adolescents to be vaccinated before engagement in sexual activity and would require parental approval and recommendations from healthcare providers. Therefore, this project aims to explore parent and healthcare provider opinions about chlamydia vaccines to identify potential barriers and facilitators to uptake. Because the COVID-19 pandemic …

History Of Allergy, Atopy, Infectious And Autoimmune Disease And Risk Of Multiple Myeloma, Tony B. Zbysinski

All ETDs from UAB

Multiple Myeloma (MM) is a plasma cell malignancy, which is defined in part by antibodies and complexes of immunoglobulin (Ig) heavy and light chains (IgH and IgL). Previous associations of immune-stimulating conditions such as allergic, autoimmune, and infectious conditions and the risk of multiple myeloma (MM) are inconsistent. However, these studies were conducted in populations of European ancestry, leaving the possibility that these conditions may contribute to the excess risk of plasma cell proliferative disorders observed among Black Americans. Therefore, we assessed MGUS, a precursor condition to myeloma, and MM risk related to a history of allergy, atopy, infections and …