Thesis (M.S.P.H.)--University of Michigan, 1937.

Thesis (M.S.P.H.)--University of Michigan, 1935.

Thesis (M.P.H.)--University of Michigan, 1943.

Thesis (M.S.P.H.)--University of Michigan, 1942.

Thesis (doctoral)--Münster, 1933. / Includes bibliographical references (p. 39-40).

Thesis (M. Phil.)--University of Hong Kong, 2005. / Title proper from title frame. Also available in printed format.

<p> Human Immunodeficiency Virus (HIV) is a substantial challenge for India. In 2011, India ranked third globally in the number of people living with HIV. While progress has been made in reducing the occurrence of new cases, there has been concern over the emergence of micro-epidemics in rural areas. Surveillance data suggests these micro-epidemics are linked to migration, where migrants serve as a bridge between the high prevalence cities and their low prevalence hometowns. </p><p> However, there appears to be a gap in the research literature when examining the rationale for why HIV is spreading beyond migrants and their partners. One reasonable theory is that the social norms in the source village significantly differ from that of the work destination. To explore this idea, a secondary quantitative analysis was conducted on data collected from 4,294 adult male migrant laborers from multiple sites across India. The Theory of Social Normative Behavior (TNSB) was used to disentangle to role of individual and group norms of the source and destination site on an individual's behavior. </p><p> This study had three major findings. First, the objective prevalence of a behavior (collective norm) had more predictive value than the individual&rsquo;s perceived estimate (descriptive norm). Second, collective norms are not moderators (contrary to TNSB), instead descriptive norms partially mediate the effect of collective norms on risk involvement. Third, the collective norm at the source village had the largest predictive value for risk involvement at both the source and destination sites.</p>

<p> Background: CDC reports that the highest percentage of newly identified HIV positives are among transgender people. They are overburdened by HIV and relatively under-researched in studies and underserved by healthcare providers. </p><p> Methods: A secondary data analysis was performed using data from a special needs assessment survey of HIV positive transgender people conducted in 2012 by the Houston Area Ryan White HIV Planning Council. Pearson&rsquo;s chi-squared (&khgr;&sup2;) or Fisher&rsquo;s exact test was conducted to assess whether HIV service utilization and barriers vary statistically by demographic characteristics. Variables with statistically significant levels less than 0.25 (P &lt; 0.25) were selected to enter into the multivariable logistic regression models. Multivariable logistic regression with backward elimination process was used to identify the significant demographic variables that are associated with HIV service utilization and barriers.</p><p> Results: HIV positive transgender people with unstable housing status were less likely to use health insurance assistance services (P=0.012); but more likely to use substance abuse treatment services (P=0.017) and nutrition services (P=0.001) than those who owned or rented housing. They were also more likely to have difficult accessing primary health care services than those who owned/rented housing (P=0.007).</p><p> HIV positive African American transgender people were more likely to use mental health services than their white counterparts (P=0.019) and the unemployed were more likely to use mental health services than the employed (P=0.002).</p><p> More educated HIV positive transgender people were more likely to use case management services (P=0.039) and less likely to have difficulty accessing them (P=0.019) than the less educated. They had lower odds of difficulty in accessing primary HIV care (P=0.018) than the less educated.</p><p> Older transgender people (age group between 25-44) were more likely to use legal services than the younger ones (age group 18-24) (P=0.021).</p><p> Conclusion: Socioeconomic status may influence the utilization and barriers of HIV services among transgender people in the Houston Area. Housing assistance program need to be tailored to reach HIV positive transgender people of low socioeconomic status. Culturally appropriate and comprehensive transgender HIV care is recommended to meet the needs of transgender minorities in the area.</p>

Aerosol particles are important components in the Earth's atmosphere. They have been shown to have the following effects: (1) visibility reductions and degrading air quality; (2) negative impact on human health; (3) modification of cloud properties and the spatiotemporal distribution of precipitation; and (4) geochemical cycling of nutrients. It is projected that southern Arizona, which is a semi-arid area, will become drier, which can lead to an enhancement of wildfire and wind-blown dust. These resulting emissions will increase total aerosol particle loading and lead to a new physicochemical signature among the region's aerosol properties. The life cycle of aerosol particles still remains uncertain, which affects our ability to forecast air quality and climate change among other effects associated with particles. The organic fraction of aerosol particles has one of the largest uncertainties in terms of what species it is comprised of and how they are made, which is related to the research described in this dissertation. Another part of this dissertation is advancing knowledge about the interaction between aerosol particles and water vapor using ground measurements and models. The first research topic is that of the role of aqueous secondary organic aerosol (SOA) formation in a semi-arid region. Water-soluble organic carbon (WSOC) and its ratio to organic properties were used as proxies of SOA. Results from ground measurements are presented, which summarized SOA formation results from enhanced moisture in Monsoon season (July-September) and enhanced emissions of biogenic volatile organic compounds (BVOCs) due to rapid plant growth. A second research study was conducted to quantify aerosol and cloud water dimethylamine (DMA) in southern Arizona and by the California coast. The study results include a summary of the DMA size distribution and its ratio to ammonium in the two regions, relationship between PM1.0 DMA and potential influencing factors, and a summary of DMA concentrations in cloud water from the California coastal region. The last part of this study includes a detailed characterization of long-term cloud condensation nuclei (CCN) concentrations at 0.2% supersaturation, aerosol composition, and aerosol size distributions in southern Arizona. The results are used to show diurnal and seasonal patterns and variability. Measured CCN concentrations are compared with modeled values in the form of closure studies. A common thread through all studies presented in this dissertation is the characterization of atmospheric aerosol physicochemical properties in southern Arizona. It is hoped that this dissertation is able to provide an impetus for continuing research on air quality and public health in semi-arid regions such as southern Arizona.

<p> The cause for adverse birth outcomes such as prematurity, low birth weight, small for gestational age, among others, is not clearly understood. Despite medical advancements, infants that overcome poor birth outcomes face significant cognitive, behavioral, and developmental challenges in their childhood and throughout their lifespan. </p><p> It has been established that some race/ethnic groups and populations in the lower economic strata are disproportionately affected by adverse birth outcomes. It is of utmost importance to continue exploring factors that contribute to race/ethnic disparities in order to develop targeted intervention strategies. In Nevada, several initiatives have been developed to address disparities in poor birth outcomes, however, the state faces challenges such as: provider shortages, long distance to hospitals and/or areas that offer health care services, low high school graduation rates, exposure to environmental tobacco smoke among casino workers, a growing prescription and illicit drug use problem, among others. </p><p> The goals of this epidemiological study were to: 1) determine whether distance was a barrier in obtaining specialized care for very low birth weight (VLBW) infants, 2) asses the association between working in the service industry and preterm birth among Hispanic women and 3) evaluate the relationship between depression, substance use, and low birth weight. </p><p> In study one, distance of more than 50 miles was found to be associated with delivery of a VLBW infant in a non-level III hospital. Study two revealed that Hispanic women working in the service industry had increased odds of preterm birth compared to those working in administrative support positions. Results of study three showed that mothers who used prescription drugs during pregnancy had higher odds of delivering a low birth weight baby. Additionally, women with a clinical diagnoses of depression prior to becoming pregnant had higher odds of using substances during pregnancy (OR: 3.51; 95% CI = 3.46&ndash;3.56) compared to women who did not have a clinical diagnoses of depression prior to pregnancy. The findings of this dissertation support avenues to further explore factors associated with adverse birth outcomes and barriers to accessing health care services among pregnant women.</p>