PhD
November 18, 2020
Assessing the Individual and Interactive Associations of Pre- and Postnatal Air Pollution Exposures and Maternal Nutrition During Pregnancy with Child Blood Pressure: A Prospective Study in a Community-based Birth Cohort
Background: Limited data suggest that the intrauterine environment and early life experience may contribute to increased child blood pressure, with effects possibly extending into adulthood. The individual and interactive effects of air pollution exposures and maternal nutrition during pregnancy upon child blood pressure are unclear. Methods: In this dissertation, we conducted two separate prospective studies…
Proximal tubular secretion, cardiovascular events, and kidney clearance of medications
Background: Current detection and monitoring of chronic kidney disease (CKD) rely primarily on glomerular filtration rate (GFR) and albuminuria. However, the kidneys perform many important functions outside of the glomerulus. Among them, the secretion of organic anions and cations by kidney proximal tubules is a vital non-glomerular function for removing retained metabolic wastes, toxins, and…
The Epidemiology, Outcomes, and Prevention of HIV-associated Meningitis in Southern Africa
Central nervous system infection are a primary cause of HIV-associated morbidity and mortality worldwide. In this dissertation, I discuss results from research conducted in Botswana, a country in southern Africa with an HIV prevalence that is among the highest in the world, including the first comprehensive meningitis national incidence estimates in a high HIV prevalence…
November 17, 2020
Depression and HIV pre-exposure prophylaxis use among sub-Saharan African Women
Daily, oral pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) is a highly efficacious HIV prevention strategy for key populations at high risk of HIV, including women, in sub-Saharan Africa. However, open-label studies and demonstration projects have reported that young women have difficulty adhering to PrEP over time, which limits its effectiveness as a prevention…
Perpetration of Interpersonal Violence, Incarceration, and Subsequent Risk for Firearm Suicide
Suicide is a major public health concern in the United States. The recent growth in the burden of suicide has disproportionately impacted marginalized communities and those of lower socioeconomic status. This dissertation uses administrative data across public health and public safety sectors to assess whether individuals have a heightened risk of suicide after release from…
Reaching underscreened women: correlates of cervical cancer underscreening, reactions to mailed HPV self-sampling kits, and cost-effectiveness of HPV self-sampling programs
Underscreening is a major risk factor for the development of cervical cancer. This dissertation examines factors associated with clinic-based Pap screening and human papillomavirus (HPV) self-sampling in a U.S. healthcare system and summarizes the existing evidence on the cost-effectiveness of HPV self-screening in order to support health system implementation of new strategies to increase cervical…
Understanding Adherence to and HIV-1 Protection from a Microbicidal Vaginal Ring
Topical vaginal microbicides and pre-exposure prophylaxis (PrEP) in the form of oral pills have been evaluated in efficacy trials for the prevention of HIV-1 infection over the past two decades with mixed results. In intention-to-treat analyses, some studies of PrEP agents, such as Truvada®, have shown positive efficacy results for reducing rates of HIV-1 infection…
Inflammatory Biomarkers, Genetics, and Survival among Colorectal Cancer Patients
Chronic inflammation significantly increases the risk of colorectal cancer (CRC) through inflammation-mediated mechanisms. Current evidence regarding the connection between circulating inflammatory biomarkers and CRC prognosis is limited to C-reactive protein (CRP) and interleukin (IL)-6. However, other inflammatory biomarkers with biologic relevance, such as monocyte chemoattractant protein-1 (MCP-1), adiponectin, and leptin, are not well understood for…
November 16, 2020
Long-Term Air Pollution in Relation to Cardiac Structure, Function, and Supraventricular Arrhythmias
Background: Air pollution is an important contributor to cardiovascular morbidity, including risk of heart failure. Acute exposure is associated with inflammation, elevation of blood pressure, and episodes of atrial fibrillation (AF). However, less is understood about how long-term exposures may influence measures of atrial and ventricular structure and function, including supraventricular arrhythmias. No large longitudinal…
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