Public Health Commons^™

Organizational Readiness For Implementation: A Qualitative Assessment To Explain Survey Responses, Maria Mcclam, Lauren Workman, Timothy J. Walker, Emanuelle M. Dias, Derek W. Craig, Joe R. Padila, Andrea E. Lamont, Abraham Wandersman, Maria E. Fernandez

Faculty Publications

Background

One factor considered essential to successful implementation is organizational readiness. The purpose of this study was to explore ways to improve the measurement of organizational readiness, and in particular to refine a preliminary measure based on the Readiness = Motivation x innovation Specific Capacity x General Capacity (R = MC2) heuristic. We assessed the experiences of staff in Federally Qualified Health Centers (FQHC) implementing evidence-based interventions (EBIs) designed to increase colorectal cancer screening (CRCS) who previously completed the survey and aimed to understand their perspectives on why our data were positively skewed.

Methods

We conducted a series of qualitative …

Toward Personalized Digital Experiences To Promote Diabetes Self-Management: Mixed Methods Social Computing Approach, Tavleen Singh, Kirk Roberts, Kayo Fujimoto, Jing Wang, Constance Johnson, Sahiti Myneni

Faculty, Staff and Student Publications

BACKGROUND: Type 2 diabetes affects nearly 34.2 million adults and is the seventh leading cause of death in the United States. Digital health communities have emerged as avenues to provide social support to individuals engaging in diabetes self-management (DSM). The analysis of digital peer interactions and social connections can improve our understanding of the factors underlying behavior change, which can inform the development of personalized DSM interventions.

OBJECTIVE: Our objective is to apply our methodology using a mixed methods approach to (1) characterize the role of context-specific social influence patterns in DSM and (2) derive interventional targets that enhance individual …

Organizational Readiness For Implementation: A Qualitative Assessment To Explain Survey Responses, Maria Mcclam, Lauren Workman, Timothy J Walker, Emanuelle M Dias, Derek W Craig, Joe R Padilla, Andrea E Lamont, Abraham Wandersman, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: One factor considered essential to successful implementation is organizational readiness. The purpose of this study was to explore ways to improve the measurement of organizational readiness, and in particular to refine a preliminary measure based on the Readiness = Motivation x innovation Specific Capacity x General Capacity (R = MC2) heuristic. We assessed the experiences of staff in Federally Qualified Health Centers (FQHC) implementing evidence-based interventions (EBIs) designed to increase colorectal cancer screening (CRCS) who previously completed the survey and aimed to understand their perspectives on why our data were positively skewed.

METHODS: We conducted a series of qualitative …

A Regularized Bayesian Dirichlet-Multinomial Regression Model For Integrating Single-Cell-Level Omics And Patient-Level Clinical Study Data, Yanghong Guo, Lei Yu, Lei Guo, Lin Xu, Qiwei Li

Faculty, Staff and Student Publications

The abundance of various cell types can vary significantly among patients with varying phenotypes and even those with the same phenotype. Recent scientific advancements provide mounting evidence that other clinical variables, such as age, gender, and lifestyle habits, can also influence the abundance of certain cell types. However, current methods for integrating single-cell-level omics data with clinical variables are inadequate. In this study, we propose a regularized Bayesian Dirichlet-multinomial regression framework to investigate the relationship between single-cell RNA sequencing data and patient-level clinical data. Additionally, the model employs a novel hierarchical tree structure to identify such relationships at different cell-type …

Nutritional, Phytochemical, And Antimicrobial Properties Of Carica Papaya Leaves: Implications For Health Benefits And Food Applications, Rajni Choudhary, Ravinder Kaushik, Ansab Akhtar, Suvendu Manna, Jyoti Sharma, Aarti Bains

School of Medicine Faculty Publications

BACKGROUND: Papaya leaves (PLs) are known for their therapeutic benefits and traditional use in treating inflammation, infections, and various health conditions. Rich in bioactive compounds, PLs are studied for their potential applications in functional foods. This study analyzed their nutritional, phytochemical, structural, thermal, and antimicrobial properties to evaluate their role as a health-promoting ingredient. METHODS: Phytochemicals were quantified spectrophotometrically and identified via GC-MS. Antioxidant activity was assessed using DPPH and FRAP assays. Mineral content was determined using ICP-OES. Structural and thermal properties were evaluated using FTIR, XRD, and calorimetry, and antimicrobial activity was tested via the agar well diffusion method. …

The Wright Brothers And Their Genetic Susceptibility To Typhoid Fever, John D. Bullock, H Bradford Hawley

Population and Public Health Sciences Faculty Publications

Importance: Typhoid fever gravely sickened Orville Wright in 1896 and the disease killed his older brother, Wilbur, in 1912. The occurrence of typhoid fever among other Wright family members has never been explored.

Objective: To investigate the number of cases of typhoid fever in the Wright brothers’ family and determine if they had a predisposition to typhoid fever that might have had a genetic basis.

Methods: Biographical information concerning the Wright brothers was examined and a family tree was constructed. Using an estimated untreated case fatality rate of 20%, typhoid fever mortality data from decennial U.S. censuses (1850-1920) was converted …

Parental Monitoring, Peer Connectedness, And Potential Exposure To Stis In Adolescents Using The Youth And Risk Behavior Survey (Yrbs) Of 2021, Allyson L. Pullen

All ETDs from UAB

Background: Adolescents are significantly affected by sexually transmitted infections (STIs), a public health challenge linked to high-risk sexual behaviors, including early sexual initiation, unprotected intercourse, multiple partners, and substance use. Protective factors such as parental monitoring and peer connectedness have demonstrated the potential to reduce adolescent risky behaviors. This study aims to examine the relationship between parental monitoring, peer connectedness, and potential exposure to STIs in high school students. Methods: This study analyzed data from the 2021 Youth Risk Behavior Survey (YRBS), focusing on potential STI exposure, parental monitoring, and peer connectedness among U.S. high school students. Potential STI exposure …

Gateways, Barriers, And Facilitators To Opioid Use Treatment For Low-Income Pregnant And Postpartum Women In The State Of Alabama, Lindsey Allison Rice Bender

All ETDs from UAB

Low income, pregnant and postpartum women who misuse opioids in the state of Alabama face potentially life-threatening challenges when seeking substance misuse treatment and recovery support services. Our study used an explanatory sequential mixed-methods approach to explore gateways, barriers, and facilitators to opioid use disorder (OUD) treatment for pregnant and postpartum women in the state of Alabama. Surveys from 32 pregnant and postpartum individuals and in-depth interviews with 15 pregnant and postpartum individuals (four pregnant, four 0-6 months postpartum, four 7-12 months postpartum and three 13-18 months postpartum) were used to identify gateways, barriers, and facilitators to OUD treatment. Our …

Predictors Of Antidepressant Use In Stroke Survivors And Evaluating The Role Of Time-Varying Depressive Symptoms On The Association Between Antidepressant Use And Stroke, Hely Divyanshu Nanavati

All ETDs from UAB

Depression is a mental health crisis affecting 21 million Americans. Consequently, antidepressants are one of the most prescribed classes of medications in the American population. Depression is also a common adverse outcome after stroke with one in three patients having depressive symptoms within the first year of their stroke recovery phase. Antidepressants are effective in the treatment and prevention of depressive symptoms in stroke patients. However, the overall antidepressant use in the acute post-stroke phase and the patient characteristics influencing the prevalence of receiving antidepressant prescriptions during acute stroke hospitalization are not known. Depression is also associated with higher risk …

The Relationship Between Molten Iron Chemistry Of A Cupola Furnace And Airborne Contaminants, Darkeya D. Rowe

All ETDs from UAB

The purpose of this research was to understand the potential relationship between the molten iron chemistry of a cupola furnace and airborne contaminants. Three-day air sampling was performed for the emissions of a cupola furnace using 37 mm mixed cellulose ester (MCE) filter cassettes at an iron foundry. The samples were analyzed for 21 elements and compounds by a commercial laboratory using the modified National Institude for Occupational Safety and Health (NIOSH) Method 7303, most of which were metals. The concentrations of 13 out of 21 elements and compounds were compared to the corresponding elements in molten metal/iron stream analyzed …

Fluorescence Lifetime Sorting Reveals Tunable Enzyme Interactions Within Cytoplasmic Condensates, Leyla E Fahim, Joshua M Marcus, Noah D Powell, Zachary A Ralston, Katherine Walgamotte, Eleonora Perego, Giuseppe Vicidomini, Alessandro Rossetta, Jason E Lee

Faculty, Staff and Students Publications

Ribonucleoprotein (RNP) condensates partition RNA and protein into multiple liquid phases. The multiphasic feature of condensate-enriched components creates experimental challenges for distinguishing membraneless condensate functions from the surrounding dilute phase. We combined fluorescence lifetime imaging microscopy (FLIM) with phasor plot filtering and segmentation to resolve condensates from the dilute phase. Condensate-specific lifetimes were used to track protein-protein interactions by measuring FLIM-Förster resonance energy transfer (FRET). We used condensate FLIM-FRET to evaluate whether mRNA decapping complex subunits can form decapping-competent interactions within P-bodies. Condensate FLIM-FRET revealed the presence of core subunit interactions within P-bodies under basal conditions and the disruption of …

Can Clinical Findings At Admission Allow Withholding Of Antibiotics In Patients Hospitalized For Community Acquired Pneumonia When A Test For A Respiratory Virus Is Positive?, Ryan Ward, Alejandro J Gonzalez, Justin A Kahla, Daniel M Musher

Faculty, Staff and Students Publications

BACKGROUND: Current guidelines recommend empiric antibiotic therapy for patients who require hospitalization for community-acquired pneumonia (CAP). We sought to determine whether clinical, imaging or laboratory features in patients hospitalized for CAP in whom PCR is positive for a respiratory virus enable exclusion of bacterial coinfection so that antibiotics can be withheld.

METHODS: For this prospective study, we selected patients in whom an etiologic diagnosis was likely to be reached, namely those who provided a high-quality sputum sample at or shortly after admission, and in whom PCR was done to test for a respiratory virus. We performed quantitative bacteriologic studies on …

Predictive Value Of Fdg Uptake On Pet For Future Immune Checkpoint Inhibitor-Mediated Colitis: A Case Series, Malek Shatila, Kei Takigawa, Yang Lu, Andres Caleb Urias Rivera, Nitish Mittal, Abdullah Sagar Aleem, Sean Ngo, Eric Lu, Deanna Wu, Gabriel Sperling, Sidra Naz, Bryan Schneider, Anusha Shirwaikar Thomas, Yinghong Wang

Faculty, Staff and Student Publications

Objectives: Immune-mediated colitis (IMC) is a common immune-related adverse event during immune checkpoint inhibitor (ICI) therapy. This case series and review aimed to highlight atypical cases of IMC and explore the potential of PET/CT to predict imminent ICI colitis.

Methods: Through a descriptive, retrospective study at a tertiary cancer center, we identified adult patients receiving ICIs for any cancer between 2010 and 2022 who also underwent PET/CT for routine cancer surveillance during this time. We included patients who had signs and symptoms of colitis and reviewed their surveillance PET/CT scans obtained 2 to 6 weeks before and up to 3 …

Rethinking The Rise Of Early-Onset Gastrointestinal Cancers: A Call To Action, Benjamin A Weinberg, Caitlin C Murphy, David R Freyer, K Leigh Greathouse, Jan K Blancato, Elena M Stoffel, Julia L Drewes, Anne Blaes, John M Salsman, Y Nancy You, Hannah Arem, Reetu Mukherji, Priyanka Kanth, Xin Hu, Anne Fabrizio, Marion L Hartley, Marios Giannakis, John L Marshall

Faculty, Staff and Student Publications

Since the early 1990s, there has been a dramatic rise in gastrointestinal cancers diagnosed in patients under age 50 for reasons that remain poorly understood. The most significant change has been the increase in incidence rates of early-onset colorectal cancer, especially rates of left-sided colon and rectal cancers. Increases in gastric, pancreatic, and other gastrointestinal cancer diagnoses have further contributed to this trend. We formed a multidisciplinary Think Tank to develop a strategic, coordinated approach to studying early-onset gastrointestinal cancers. This area of research is challenging given multifactorial etiologies. We focused on epidemiology and the environment, the microbiome, and survivorship …

Faecal Excretion Of Thorium By Norm Workers, Gregory S. Hewson, Martin Ralph, Marcus Cattani

Research outputs 2022 to 2026

Exposure to thorium-bearing dust in industries handling and processing monazite and other minerals can pose radiological risks to workers. This study aimed to reassess historical faecal bioassay data collected over 10 d from two monazite plant workers using updated biokinetic and dosimetric models. Another objective was to evaluate the feasibility of faecal thorium bioassay for contemporary operations involving naturally occurring radioactive materials (NORM). The retrospective analysis found that the bioassay-derived thorium intakes were significantly higher than those estimated via personal air sampling. The effective dose estimates for the two workers were similar and ranged from 0.95 to 2.40 mSv over …

Covid-19 Vaccine Hesitancy Among Black Women In The Us, Brittany C Slatton, Farrah G Cambrice, Serwaa S Omowale

Faculty, Staff and Student Publications

IMPORTANCE: COVID-19 vaccine hesitancy among Black women is a critical public health concern, potentially exacerbating existing health disparities and impacting community-wide vaccination efforts.

OBJECTIVE: To explore the factors associated with COVID-19 vaccine hesitancy among Black women in the US and identify the specific concerns and experiences shaping hesitant attitudes toward vaccination.

DESIGN, SETTING, AND PARTICIPANTS: Qualitative study using in-depth, semistructured interviews conducted virtually between June and November 2021. Thematic analysis was used to identify key themes from the interview data. Participants were recruited through social media platforms and word-of-mouth referrals from various regions of the US. Interviews were conducted remotely …

Are We Underestimating Exposures From Norm Dust?, Gregory S. Hewson, Martin Ian Ralph, Marcus Cattani

Research outputs 2022 to 2026

The inhalation of dust containing naturally occurring radioactive materials (NORM) associated with mining and mineral processing operations may lead to potential long-term health impacts, including cancer and chronic lung disease, due to alpha particle-emitting radionuclides. This study evaluates the effectiveness of air sampling strategies used to estimate radiation doses from NORM exposure, with a focus on the Western Australian minerals industry. The objectives were to review current sampling and analysis protocols, identify factors contributing to over- or underestimation of dose, and propose adjustments to improve intake assessments. A review of research and guidelines applicable to NORM dust exposure was conducted, …

Lusaka's Colonial Legacy: Town Planning, Public Health, And The Making Of A Segregated City, 1913–1963. A Study Of Power, Inequality, And Urban Development, Wamburakwao J. Sapao

Zambia Social Science Journal

This paper explores the intersection of town planning and public health policy in Lusaka, Northern Rhodesia (now Zambia), during the colonial period (1913–1963), which was a time of significant urban growth and transformation. British colonial authorities adapted Ebenezer Howard's Garden City principles to design and manage Lusaka, but these measures perpetuated spatial control, segregation, and social engineering, thus exacerbating racial and socio-economic disparities. By analysing secondary and primary sources, including planning ordinances, zoning regulations, and public health policies, this study reveals how these measures shaped the city's development and reinforced inequalities. Despite colonial intentions for a white settler-city, Lusaka evolved …

Beyond The Numbers: A Qualitative Exploration Of Patient Perspectives On Postpartum Care And Maternal Mortality, Kristen A. Waters

Master of Public Health Program Student Publications

Introduction

Montgomery County faces one of Ohio's highest maternal mortality rates, with notable disparities by race. Despite their importance in reducing maternal deaths, up to 40% of women nationwide do not attend a postpartum care (PPC) visit. While well researched guidelines exist regarding the content and timing of PPC visits, there is a lack of patient perspective on this topic, specifically in the Black-identifying population in an area with a significant burden of maternal mortality.

Methods

Semi-structured interviews and focus group sessions were conducted with 31 participants of maternal health community events in Dayton, OH. Participants were asked their opinions …

Suicide Exposure In The Army National Guard: A Three Manuscript Dissertation, Rebecca Willis-Nichols

Theses and Dissertations--Social Work

Between 2000-2022, the U.S. suicide rate increased 36% with one death now occurring every 11 minutes (CDC, 2024). Despite the Department of Defense making a concerted effort to curb the suicide increases in their ranks, the rates have continued to rise. Active-duty component rates have slowly increased since 2011 while reserve and guard components have held steady (U.S. Department of Defense, 2023). After adjusting for age, the suicide rate in the veteran population was 57% greater than the civilian population in 2020 (CDC, 2024). There is a need for a better understanding of the impact of these deaths and the …

Long Commute Time And Association With Physical And Mental Health Variables, Nate Hopper, Gitty Goldstein, Meytal Guller

Scholarship in Medicine - All Papers

Commuting to work or school is a common choice influenced by financial, social, or personal reasons, and it is important to ascertain whether this choice comes with negative health detriments. Using the county health data from 2016 and 2023 publicly available on the County Health Ranking and Roadmaps website, we conducted a retrospective review to see what health outcomes may be associated with a long commute. We looked at six different states, Ohio, Kentucky, Indiana, West Virginia, Pennsylvania, and Michigan. We found a very weak correlation between commute and insufficient sleep, median household income, physical inactivity, mental stress, and diabetes. …

Lung-Delivered Il-10 Mitigates Lung Inflammation Induced By Repeated Endotoxin Exposures In Male Mice, Aaron Schwab, Todd A. Wyatt, Oliver Schanze, Amy J. Nelson, Angela Gleason, Michael J. Duryee, Deanna Mosley, Geoffrey M. Thiele, Ted R. Mikuls, Jill A. Poole

Journal Articles: Environmental, Agricultural & Occupational Health

Therapies capable of resolving inflammatory lung disease resulting from high-consequence occupational/environmental hazards are lacking. This study seeks to determine the therapeutic potential of direct lung-delivered interleukin (IL)-10 following repeated lipopolysaccharide exposures. C57BL/6 mice were intratracheally instilled with LPS (10 μg) and treated with IL-10 (1 μg) or vehicle control for 3 days. Lung cell infiltrates were enumerated by flow cytometry. Lung sections were stained for myeloperoxidase (MPO), CCR2, vimentin, and post-translational protein citrullination (CIT) and malondialdehyde-acetaldehyde (MAA) modifications. Lung function testing and longitudinal in vivo micro-CT imaging were performed. Whole lungs were profiled using bulk RNA sequencing. IL-10 treatment reduced …

Lung Disease In Relation To Unique Monocyte-Macrophage Subpopulations Induced By Combined Inhalant Endotoxin And Collagen-Induced Arthritis, Jill A. Poole, Aaron Schwab, Geoffrey M. Thiele, Todd A. Wyatt, Amy J. Nelson, Oliver Schanze, Angela Gleason, Michael J. Duryee, Bryant England, Ted R. Mikuls

Journal Articles: Environmental, Agricultural & Occupational Health

BACKGROUND: Lung disease is the most overrepresented cause of death in rheumatoid arthritis (RA). Animal studies have demonstrated potentiated autoimmunity, arthritis, and profibrotic/inflammatory lung disease with a combination of airborne exposures and collagen-induced arthritis (CIA), a model that recapitulates features of RA-associated interstitial lung disease (RA-ILD). As patients with RA-ILD demonstrate unique circulating monocyte subpopulations, this study aims to characterize lung infiltrating monocytes/macrophages in a mouse model of RA-ILD and determine whether reducing these cells mitigates the development of lung disease.

METHODS: Autoimmune-prone DBA/1J mice received intranasal inhalation of lipopolysaccharide (LPS) daily for up to 5 weeks and CIA induction. …

Temporal Trends And Patterns For Early- And Late-Onset Adult Liver Cancer Incidence Vary By Race/Ethnicity, Subsite, And Histologic Type In The United States From 2000 To 2019, Mei-Chin Hsieh, Kendra L. Ratnapradipa, Laura Rozek, Shengdi Wen, Yu-Wen Chiu, Edward S. Peters

Journal Articles: Epidemiology

PURPOSE: To examine incidence trends and patterns for early- and late-onset liver cancer.

METHODS: Liver and intrahepatic bile duct (IBD) cancers diagnosed between 2000 and 2019 were acquired from 22 SEER registries. Variables included early-onset (20-49) vs. late-onset (50+), anatomic subsite, histologic type (hepatocellular carcinoma [HCC] and IBD cholangiocarcinoma [ICC]), sex, and race/ethnicity. Age-standardized incidence rates were calculated using SEER*Stat. Jointpoint regression analysis was employed to estimate the annual percent change (APC) and the average APC (AAPC) with pairwise comparisons for trend by sex and by race/ethnicity stratified by age and subsite.

RESULTS: Liver cancer incidence decreased among early-onset (AAPC …

Factors Associated With Std Hospital Admissions In South Carolina Hospitals (2020-2024), Darrell Holmes, Dennis Besong

South Atlantic Division GME Research Day 2025

No abstract provided.

Artificial Intelligence In Health Care: Business Opportunities And Ethical Challenges, Ankita Srivastava,, Marco Marabelli, Jeffrey Moriarty

Ethics Publication

Artificial intelligence (AI), and in particular generative AI (GAI), are making incredible progress toward automation. The pervasive and invasive nature of these technologies are affecting every industry, and health care is no exception. This paper summarizes insights derived from a panel that the Hoffman Center for Business Ethics and the Center for Health and Business at Bentley University hosted in March 2024. The panel invited three qualified health care professionals: Evan Carey, Susan Persky and John Torous. The panelists are all active in multiple aspects of AI in health care but represent a focus on the key areas of policy …

Covid-19 Taking Aim At The Heart Of Public Education, Jeremy James Pyle

Theses, Dissertations and Capstones

The COVID-19 pandemic, distinguished by both its duration and widespread impact, stands apart from other crises typically faced by schools, such as natural disasters, school violence, or isolated traumatic incidents. Unlike these shorter-term events, the pandemic fundamentally altered the educational landscape, reshaping both school climate and instructional practices. This non-experimental, descriptive study employed a phenomenological research approach to examine the lived experiences of teachers during and after the pandemic. The central aim was to explore how pandemic-related stressors influenced teachers’ decisions to remain in or leave the profession, as well as to identify the supports educators perceived as necessary for …

Investigating The Relationship Between Adult Obesity And Various Socio-Economic Factors In Ohio, Medhavi Anand, Nicholas Gural

Scholarship in Medicine - All Papers

Background: Obesity continues to be a significant concern in the United States for decades. While several advancements in the field of medicine have been established over the years, obesity has been a serious issue in the adult population in terms of its resources and cost. Objective: The aim is to direct and explore how obesity is linked to various factors such as median household income, access to exercise opportunities, excessive drinking and diabetes prevalence in the state of Ohio.
Methods: Data was collected from the County Health Rankings website from the years 2016 and 2023. Data analytics were done using …

From Stress To Social Context: Examining The Drivers Of Excessive Drinking, Esha Kulkarni, Rudra Gandhi

Scholarship in Medicine - All Papers

Investigating different variables and the impact they have on excessive drinking can help us enhance our population’s overall quality of life. Our research examined key variables, including social associations, unemployment, education level, rural residency, mental health, physical distress, and access to mental health providers.
In Ohio, excessive drinking rates increased significantly between 2016 and 2023, coinciding with a decline in social association rates. A moderate positive correlation was identified between excessive drinking and educational attainment (r = .480, p < .001), suggesting increased alcohol use in more educated populations. Unexpectedly, a weak negative correlation emerged between unemployment and excessive drinking, challenging conventional assumptions. Additionally, the prevalence of frequent poor mental health in Ohio rose remarkably between 2016 and 2023, underscoring the growing burden of mental health challenges. Interestingly, no significant correlations were found between excessive drinking and rural residency or the availability of mental health providers. Lastly, a significant 37% of the variance in excessive drinking was explained by frequent physical distress, highlighting alcohol's potential role as a coping mechanism.
These results underscore the multifaceted nature of excessive drinking and its ties to societal and individual stressors. Addressing these issues through …

An Investigation Into The Use Of Rates Of Uninsurance As A Marker For Community Health In The State Of Ohio, Ashni Patel, Bayley Mcritchie

Scholarship in Medicine - All Papers

Objective: Previous studies have shown a correlation between rates of uninsurance and worse health outcomes. However, the efficacy of utilizing uninsurance rates as a marker for community health has not been clearly shown. Therefore, this study investigates how rates of uninsurance in Ohio correlate with worse health outcomes, as well as how Ohio counties utilize health insurance.
Methods: County Health Rankings was used look at rates of uninsurance among adults and children in Ohio along with diabetes prevalence, preventable hospitalizations, and premature death. T-tests, ANOVA, and Pearson and Spearman correlations were utilized to determine the effects of uninsurance rates on …