Public Health Commons^™

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

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 …

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 …

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.

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 …

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 …

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

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. …

Soft X-Ray And Susceptibility Based Magnetic Resonance Imaging To Map Iron Distribution In Apples: Initial Results To Model Iron Storage In Water-Deficient Or Dehydrated Biological Tissue, Subhendra N. Sarkar, Eric Lobel, Evans Lespinasse, Zoya Vinokur, Analia Basilicata, Sonia Orellana, Maria Orellana, Aaliyah Salmon, Joanna Syska, Aravis Mcbroom, Jian Wang, Anam Riaz, Jodi-Ann Douglas

Publications and Research

Radiology departments have contributed significantly to greenhouse gases including release of toxic imaging contrast media to environment. We feel Radiology also has several spectroscopy and imaging tools that may apply to monitor and support cleaner environmental goals. The current manuscript is one of the firsts to prompt Radiology to move in that direction by non invasive imaging of bio metals that are less abundant in biological tissues but play key roles as co-factors in tissue structure and function. Conventional analytical tools are mostly invasive and cannot characterize the native oxidation states of bio metals. We chose carbohydrate matrix of metal-rich …

Validation Of An Emg Submaximal Method To Calibrate A Novel Dynamic Emg-Driven Musculoskeletal Model Of The Trunk: Effects On Model Estimates, Amir H. Eskandari, Farshid Ghezelbash, Aboulfazl Shirazi-Adl, Denis Gagnon, Hakim Mecheri, Christian Larivière

Études primaires

Background

Multijoint EMG-assisted optimization models are reliable tools to predict muscle forces as they account for inter- and intra-individual variations in activation. However, the conventional method of normalizing EMG signals using maximum voluntary contractions (MVCs) is problematic and introduces major limitations. The sub-maximal voluntary contraction (SVC) approaches have been proposed as a remedy, but their performance against the MVC approach needs further validation particularly during dynamic tasks.

Methods

To compare model outcomes between MVC and SVC approaches, nineteen healthy subjects performed a dynamic lifting task with two loading conditions.

Results

Results demonstrated that these two approaches produced highly correlated results …

Improving Cervical Cancer Screening In Sub-Saharan Africa, Nigeria: Reaching Levels Of Cervical Cancer Prevention In Developed Countries, Chigozie Alexandra Ogwara, Biyi-Olutunde Olusegun, Yelena Tarasenko

Eagles Talking About the Public’s Health

No abstract provided.

Addressing Racial Disparities In Maternal Health Through Policy, Alexandria Alford, Alisha Riggins, Joanne Chopak-Foss, Sarah Sejoro, Tobi Oloyede, Mambwe Mutiti

Eagles Talking About the Public’s Health

No abstract provided.

Accessibility And Comprehension Of United States Health Insurance Among International Students: A Gray Area, Queeneth C. Edwards, Stacy Smallwood

Eagles Talking About the Public’s Health

No abstract provided.

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

College of Graduate Studies: Theses & Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

My Baby, My Move+: Feasibility Of A Community Prenatal Wellbeing Intervention, Jenn A. Leiferman, Rachael Lacy, Jessica Walls, Charlotte V. Farewell, Mary K. Dinger, Danielle Symons Downs, Sarah S. Farrabi, Jennifer L. Huberty, James F. Paulson

Psychology Faculty Publications

Background

Excessive gestational weight gain (EGWG), insufficient prenatal physical activity and sleep, and poor psychological wellbeing independently increase risks for adverse maternal and infant outcomes. A novel approach to mitigate these risks is utilizing peer support in a community-based prenatal intervention. This study assessed the feasibility (acceptability, demand, implementation, and practicality) of a remotely delivered prenatal physical activity intervention called My Baby, My Move + (MBMM +) that aims to increase prenatal physical activity, enhance mood and sleep hygiene, and reduce EGWG.

Methods

Participants were recruited through community organizations, local clinics, and social media platforms in the Fall of 2020 …

The Potential And Peculiarities Of Perma: A Meta-Analysis Of Two Well-Being Measures With Working Samples, William P. Jimenez, Xiaoxiao Hu, Rebecca Garden, Asiye Zeytonli

Psychology Faculty Publications

In the first meta-analysis of the PERMA well-being framework (i.e., positive emotions, engagement, positive relationships, meaning, accomplishment), we cumulated 692 effect sizes (k = 33 independent samples, N = 10,050 workers). Average reliability did not meet the conventional ɑ = .70 threshold for engagement measured with the PERMA-Profiler or the Workplace PERMA Profiler or for negative emotions measured with the former. Overall, PERMA dimensions were strongly intercorrelated, and model comparisons suggested multidimensionality. We also summarized PERMA’s relationships with some conceptual antecedents (conscientiousness, loneliness); correlates (happiness, negative emotions); and outcomes (physical health, depressive symptoms, overall …

A Theory Of The Covid-19 Pandemic’S Impact On The Government-Citizen Relationship / Teorija Vpliva Pandemije Covid-19 Na Odnos Med Vlado In Državljani, Lewis Luartz

Political Science Faculty Articles and Research

This paper explores how crises, such as the COVID- 19 pandemic, can impact political behavior amid restrictions. Specifically, this paper builds a theoretical model suggesting the pandemic promoted restriction-oriented policies from the government in response to the crisis while promoting populist tendencies among citizens who disagree with those policies. Moreover, through a formal two-player extensive form game, the model promoted in this paper suggests restrictions are unpopular enough that citizens may push back on such policies regardless of crisis severity. The theoretical outcomes here have significant implications on governance, given that politicians care about re-election.

Meta-Analysis Of Factors Impacting Reading Impairment Rates In Studies Of Children With Developmental Language Disorder (Dld), Kayla Dewey

Theses and Dissertations

Purpose - Developmental language disorder (DLD) is a common yet underdiagnosed disorder centered on difficulties with oral language, and often associated with word reading and reading comprehension difficulties. Numerous studies have documented high rates of reading impairment in children with DLD, but the specific rates vary widely across studies. The purpose of this meta-analysis was to help provide accurate prognostic information about this disorder by determining the average proportion of participants with DLD who also had reading impairment, and to determine whether variability in the rate of reading impairment was significantly influenced by studies’ methodological features, including recruitment method, type …

Marine And Human Environmental Factors Influence Vibrio Parahaemolyticus And Vibrio Vulnificus In Vitro Biofilm Processes On Plastics, Ryan Eric Leighton

Theses and Dissertations

Marine bacteria often exist in biofilms as communities attached to surfaces, like plastic. Growing concerns exist regarding marine plastics acting as potential vectors of pathogenic Vibrio, especially in a changing climate. It has been generalized that Vibrio vulnificus and Vibrio parahaemolyticus often attach to plastic surfaces. Different strains of these Vibrios exist having different growth and biofilm forming properties. This work evaluated how temperature and strain variability affect V. parahaemolyticus and V. vulnificus biofilm formation and characteristics on glass (GL), low-density polyethylene (LDPE), polypropylene (PP), and polystyrene (PS). This work also evaluated how human body related factors like temperature, …

The Effects Of Dental Hygiene Instrument Handles On Muscle Activity Production, Jessica R. Suedbeck, Daniel Russell, Cortney Armitano Lago, Emily A. Ludwig

Dental Hygiene Faculty Publications

Purpose The objective of this study was to compare the effects of ten commercially available instrument handle designs’ mass and diameter on forearm muscle activity during a simulated periodontal scaling experience.

Methods A convenience sample of 25 registered dental hygienists were recruited for this IRB-approved study. Ten commercially available instruments were categorized into four groups based on their masses and diameters: large diameter/light mass, small diameter/light mass, large diameter/heavy mass, and small diameter/heavy mass. Participants were randomized to four instruments with one from each group. Participants scaled with each instrument in a simulated oral environment while muscle activity was collected …

Effect Of Relaxation Intervention On Stress Levels And Cognitive Skills In Professional Students, Sandhra Sabu, Ravikiran Kisan, . Swapnali

Digital Journal of Clinical Medicine

Background: Medical Professional training is likely to encounter a variety of hassles and stress in relation to the developmental tasks associated with transition from school life to professional college life. The vast syllabus, peer competition for academic performance, continuous evaluation, and long duration of the training makes medical education stressful. Many students feel a need to relieve stress and it is a necessity to equip students with proven techniques to reduce stress and cope up with the situation. Proper cognitive functioning has been found to be an important factor for academic performance.

Methods: The present study is a cross …

Fostering A High-Functioning Team In Cancer Care Using The 4r Oncology Model: Assessment In A Large Health System And A Blueprint For Other Institutions, Raymond Liu, Christine B Weldon, Elizabeth Linehan, Nancy Gordon, Thea Abbe, Marti Hennings, Henie James, Jed Katzel, Chun Ng, Megumi Tomita, Jeffrey B Velotta, Stephanie Ossowski, Lori C Sakoda, Sharon Likely Sprague, Anna Dowling, Kimberly Beringer, Arliene Ravelo, Elaine Yu, Julia R Trosman

Faculty, Staff and Student Publications

PURPOSE: Delivering cancer care by high-functioning multidisciplinary teams promises to address care fragmentation, which threatens care quality, affects patient outcomes, and strains the oncology workforce. We assessed whether the 4R Oncology model for team-based interdependent care delivery and patient self-management affected team functioning in a large community-based health system.

METHODS: 4R was deployed at four locations in breast and lung cancers and assessed along four characteristics of high-functioning teams: recognition as a team internally and externally; commitment to an explicit shared goal; enablement of interdependent work to achieve the goal; and engagement in regular reflection to adapt objectives and processes. …

Cardiovascular Disease Risk Factors Among Middle-Aged And Older Adult Vietnamese American Members Of A Northern California Health Plan, Donna B Haysbert, Joan C Lo, Nirmala D Ramalingam, Nancy P Gordon

Faculty, Staff and Student Publications

OBJECTIVE: There is increasing recognition that cardiovascular disease (CVD) risk factors vary by Asian subgroups. We examined CVD risk factor prevalence among Vietnamese adults in a northern California health plan.

METHODS: We used electronic health record data to examine smoking, overweight/obesity (body mass index ≥23.0 kg/m

RESULTS: Current smoking prevalence was 20.3% for middle-aged men, 7.0% for older men, and

CONCLUSIONS: Study results suggest that more research on health conditions, lifestyle, and social factors among Vietnamese American adults is needed to develop culturally competent interventions to reduce CVD risk in this growing ethnic group.

In Utero Ethanol Exposure Induces Mitochondrial Dna Damage And Inhibits Mtdna Repair In Developing Brain, Nune Darbinian, Armine Darbinyan, Nana Merabova, Myrna Kassem, Gabriel Tatevosian, Shohreh Amini, Laura Goetzl, Michael E Selzer

Faculty, Staff and Student Publications

Introduction

Mitochondrial dysfunction is postulated to be a central event in fetal alcohol spectrum disorders (FASD). People with the most severe form of FASD, fetal alcohol syndrome (FAS) are estimated to live only 34 years (95% confidence interval, 31 to 37 years), and adults who were born with any form of FASD often develop early aging. Mitochondrial dysfunction and mitochondrial DNA (mtDNA) damage, hallmarks of aging, are postulated central events in FASD. Ethanol (EtOH) can cause mtDNA damage, consequent increased oxidative stress, and changes in the mtDNA repair protein 8-oxoguanine DNA glycosylase-1 (OGG1). Studies of molecular mechanisms are limited by …

Dna Release From Plant Tissue Using Focused Ultrasound Extraction (Fuse), Alexia Stettinius, Hal Holmes, Qian Zhang, Isabelle Mehochko, Misa Winters, Ruby Hutchison, Adam Maxwell, Jason Holliday, Eli Vlaisavljevich

Faculty, Staff and Student Publications

PREMISE: Sample preparation in genomics is a critical step that is often overlooked in molecular workflows and impacts the success of downstream genetic applications. This study explores the use of a recently developed focused ultrasound extraction (FUSE) technique to enable the rapid release of DNA from plant tissues for genetic analysis.

METHODS: FUSE generates a dense acoustic cavitation bubble cloud that pulverizes targeted tissue into acellular debris. This technique was applied to leaf samples of American chestnut (

RESULTS: We observed that FUSE can extract high quantities of DNA in 9-15 min, compared to the 30 min required for control …

Association Between Giving Birth During The Early Coronavirus Disease 2019 (Covid-19) Pandemic And Serious Maternal Morbidity, Torri D Metz, Rebecca G Clifton, Brenna L Hughes, Grecio J Sandoval, William A Grobman, George R Saade, Tracy A Manuck, Monica Longo, Amber Sowles, Kelly Clark, Hyagriv N Simhan, Dwight J Rouse, Hector Mendez-Figueroa, Cynthia Gyamfi-Bannerman, Jennifer L Bailit, Maged M Costantine, Harish M Sehdev, Alan T N Tita, George A Macones

Faculty, Staff and Student Publications

OBJECTIVE: To evaluate whether delivering during the early the coronavirus disease 2019 (COVID-19) pandemic was associated with increased risk of maternal death or serious morbidity from common obstetric complications compared with a historical control period.

METHODS: This was a multicenter retrospective cohort study with manual medical-record abstraction performed by centrally trained and certified research personnel at 17 U.S. hospitals. Individuals who gave birth on randomly selected dates in 2019 (before the pandemic) and 2020 (during the pandemic) were compared. Hospital, health care system, and community risk-mitigation strategies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in response to the early …

Retroperitoneal Hematoma As An Atypical Presentation Of Choriocarcinoma: A Case Report, Truce Pham, Danica Lapid, Kathleen M Schmeler, J Alejandro Rauh-Hain, Mateo G Leon

Faculty, Staff and Student Publications

A 38-year-old female with an etonogestrel implant in place and history of previous ectopic pregnancy presented with acute abdominal pain and vaginal bleeding. She was found to have a beta-hCG of >12,000 mIU/mL and free fluid noted on a focused assessment with sonography in trauma exam. She underwent an emergent diagnostic laparoscopy due to the suspicion of a ruptured ectopic pregnancy. Findings at the time of surgery included a normal-appearing uterus and left fallopian tube, a surgically absent right fallopian tube and large volume hemoperitoneum with a rapidly expanding left retroperitoneal hematoma. A postoperative computerized tomography (CT) angiogram suggested active …

Futility In Acute Care Surgery: First Do No Harm, Melissa Hornor, Uzer Khan, Michael W Cripps, Allyson Cook Chapman, Jennifer Knight-Davis, Thaddeus J Puzio, Bellal Joseph

Faculty, Staff and Student Publications

The consequences of the delivery of futile or potentially ineffective medical care and interventions are devastating on the healthcare system, our patients and their families, and healthcare providers. In emergency situations in particular, determining if escalating invasive interventions will benefit a frail and/or severely critically ill patient can be exceedingly difficult. In this review, our objective is to define the problem of potentially ineffective care within the specialty of acute care surgery and describe strategies for improving the care of our patients in these difficult situations.