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PubMedDate not supplied

The Alabama Eye Bank: 25 years of giving sight.

Modern Eye Banking had its start in the mid-1940's. However, it was not until the 1960's that eye banking grew to become a movement or even a necessary part of the health care delivery system in the state of Alabama. The Alabama Eye Bank has grown rapidly to become one of the largest corneal processing networks in the United States. Corneal transplant surgery remains highly successful in restoring sight. The contraindications for donor tissue should be clarified to all physicians and other health care professionals. The public should be make aware of the vision care available to them in the state of Alabama. The general public should be aware of how to become a pre-pledged eye donor, of research, teaching and transplantable tissue and also how they can be assured that their wishes are carried out at the time of their demise. Even with scheduled transplant surgery for all Alabamians, the need for the general public and medical professionals to be oriented and educated towards multi-organ and tissue donations is important.

Alabama↗
PubMed2002

HLA-A and -B alleles and haplotypes in hemochromatosis probands with HFE C282Y homozygosity in central Alabama.

BACKGROUND: We wanted to quantify HLA-A and -B allele and haplotype frequencies in Alabama hemochromatosis probands with HFE C282Y homozygosity and controls, and to compare results to those in other populations. METHODS: Alleles were detected using DNA-based typing (probands) and microlymphocytotoxicity (controls). RESULTS: Alleles were determined in 139 probands (1,321 controls) and haplotypes in 118 probands (605 controls). In probands, A*03 positivity was 0.7482 (0.2739 controls; p = or < 0.0001; odds ratio (OR) 7.9); positivity for B*07, B*14, and B*56 was also increased. In probands, haplotypes A*03-B*07 and A*03-B*14 were more frequent (p < 0.0001, respectively; OR = 12.3 and 11.1, respectively). The haplotypes A*01-B*60, A*02-B*39, A*02-B*62, A*03-B*13, A*03-B*15, A*03-B*27, A*03-B*35, A*03-B*44, A*03-B*47, and A*03-B*57 were also significantly more frequent in probands. 37.3% of probands were HLA-haploidentical with other proband(s). CONCLUSIONS: A*03 and A*03-B*07 frequencies are increased in Alabama probands, as in other hemochromatosis cohorts. Increased absolute frequencies of A*03-B*35 have been reported only in the present Alabama probands and in hemochromatosis patients in Italy. Increased absolute frequencies of A*01-B*60, A*02-B*39, A*02-B*62, A*03-B*13, A*03-B*15, A*03-B*27, A*03-B*44, A*03-B*47, and A*03-B*57 in hemochromatosis cohorts have not been reported previously.

Journal Article↗
PubMed1991

Heat illness in football players in Alabama.

Fall football practice in Alabama generally begins during the later months of summer during some of the hottest periods of the year. Exercise during these periods significantly exposes young athletes to risks of heat illness and possible death and is made even more dangerous while training in full football uniform. In order to delineate specific guidelines to reduce the risk of heat illness, optimal practice times and fluid replacement schedules were studied for the state of Alabama. A review of five-year climatological data (1984-1988) for the months of August and September were conducted for four geographic regions of the state. A study of the data revealed that there were no environmental combinations at any time periods during the month of August for any locale in the state that would be considered safe for outdoors practice in full uniform. Similar results were recorded for September for cities in the south-central portion of the state. There were only two time periods during which players could practice outdoor with extreme caution. The periods were at 0900 and 1800 hrs in the north-central and northern portions of the state. If practice is conducted outdoors in Alabama during August and September, copious amounts of water should be consumed prior to practice; frequent water breaks should be scheduled throughout practice at which time each player should consume 150 - 200 ml; and the player should be carefully monitored for signs of heat illness.

Football↗
PubMed1995

Gun ownership and counseling of Alabama pediatricians.

OBJECTIVE: To examine the personal behavior of primary care pediatricians in Alabama with respect to a gun control policy. The American Academy of Pediatrics supports removal of handguns from homes, safe gun storage in homes with guns, and counseling patients about gun safety practices. DESIGN: Survey. SETTING: Primary care pediatricians. PATIENTS OR OTHER PARTICIPANTS: Population-based sample. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The proportion of pediatricians who were gun and handgun owners was examined. In addition, the safety behaviors and counseling practices reported by pediatricians were examined. RESULTS: The response rate for pediatricians was 67%. Fifty percent of pediatricians reported owning a gun. Thirty-four percent of pediatricians had a handgun in their household. Eleven percent of pediatricians had unsafe gun practices, where unsafe was defined as having a loaded gun in the home or car at least some of the time. The most common reason for owning a handgun or having a loaded gun in the home or car was personal protection. Only a third (33%) of pediatricians routinely counseled their patients about gun safety. Long gun owners were less likely to counsel patients about bike helmet safety and were less likely to use car seats and bike helmets for their own children. CONCLUSIONS: A large proportion of Alabama pediatricians are gun owners, but most store weapons safely. Although long gun owners were less likely to use car seats or bike helmets and less likely to counsel patients regarding bike helmet use, no effect of gun ownership on counseling about gun safety was identified.

Adult↗
PubMed2002

Economic-environmental modeling of point source pollution in Jefferson County, Alabama, USA.

This paper uses an integrated economic-environmental model to assess the point source pollution from major industries in Jefferson County, Northern Alabama. Industrial expansion generates employment, income, and tax revenue for the public sector; however, it is also often associated with the discharge of chemical pollutants. Jefferson County is one of the largest industrial counties in Alabama that experienced smog warnings and ambient ozone concentration, 1996-1999. Past studies of chemical discharge from industries have used models to assess the pollution impact of individual plants. This study, however, uses an extended Input-Output (I-O) economic model with pollution emission coefficients to assess direct and indirect pollutant emission for several major industries in Jefferson County. The major findings of the study are: (a) the principal emission by the selected industries are volatile organic compounds (VOC) and these contribute to the ambient ozone concentration; (b) the direct and indirect emissions are significantly higher than the direct emission by some industries, indicating that an isolated analysis will underestimate the emission by an industry; (c) while low emission coefficient industries may suggest industry choice they may also emit the most hazardous chemicals. This study is limited by the assumptions made, and the data availability, however it provides a useful analytical tool for direct and cumulative emission estimation and generates insights on the complexity in choice of industries.

Alabama↗
PubMed2003

Mercury occurrence in prothonotary warblers (Protonotaria citrea) inhabiting a National Priorities List site and reference areas in southern Alabama.

Mercury occurrence in prothonotary warblers (Protonotaria citrea) was evaluated over two years in southern Alabama. Mercury was found in warbler nestlings and adults inhabiting National Priority List (NPL) sites in McIntosh, Alabama. Food items that were collected from nestlings also contained elevated mercury. When mercury concentrations in soil, food, and nestling were plotted at each nest box location, the distribution of mercury in the three matrices yielded information that direct bioaccumulation factors could not. There were site differences in mercury accumulation in nestlings inhabiting the NPL sites. Nestling mercury accumulation correlated with solid mercury concentrations near the nest box where the nestling was raised. Trophic transport of mercury was poorly defined by mercury in food; however, closer examination of prey items shows that food source influences accumulation. Mercury distributions in matrices provide useful information of uptake that can be integrated with risk assessment endpoints.

Alabama↗
PubMed1983

Neonatal deaths in Alabama, 1970-1980: an analysis of birth weight- and race-specific neonatal mortality rates.

Alabama birth and death certificate tapes for the years 1970-1980 were linked and analyzed to determine race-specific birth weight and neonatal mortality rate distributions. Changes which occurred over time were evaluated. Our analyses demonstrated that there were no substantial changes in birth weight distributions which could account for the nearly 50% reduction in the neonatal mortality rate in Alabama during this period. Birth weight changes did result in a 12% decrease in the white neonatal mortality rate but resulted in no decrease in the nonwhite neonatal mortality rate. All other improvement in the neonatal mortality rate is attributed to better survival within birth weight groups. Eighty percent of the reduction in the neonatal mortality rate during this period of time occurred in low-birth weight infants with most of the reduction found in infants weighing between 1,000 and 2,000 gm. Improvements in the quality of medical care and better access to medical care through regionalization of perinatal services, especially for low-birth weight infants, are suggested as the major reasons for this improvement.

Black or African American↗
PubMed1991

Contraceptive female sterilization in Alabama: a replication of the WHO study.

The prevalence of female sterilization for contraceptive purposes has grown rapidly throughout the world, and is especially high in the United States. Yet the psychosocial impact of female sterilization is incompletely understood. Much of the previous research has been retrospective and has lacked comparison groups of women using other methods. Better designed, prospective studies have been needed, and the World Health Organization's Collaborative Prospective Study of Female Sterilization was conducted to address this need. No evidence was found in the WHO study of a significant impact of tubal ligation compared to other contraceptive methods on mental health, menstruation, or sexual satisfaction. The present study, a replication of the WHO study, compared 323 Alabama women undergoing elective contraceptive sterilization with 318 women using other techniques to control fertility. In general, the results supported the WHO study conclusions. Although sterilization produced a small increase in menstrual distress in Alabama, there were no significant differences between sterilization and comparison women in mental health or sexual satisfaction.

Adult↗
PubMed2005

Nitrate contamination in private wells in rural Alabama, United States.

Nitrate-N (NO(3)(-)-N) concentrations in random water samples from rural residential wells in Alabama, USA, were analyzed over an 8-year period from 1992 to 1999. Data collected included land use, well depth, septic tank use and distance from the well and also livestock and cropping activities around wells. Of 1021 available data sets, 36% of samples showed nitrate-N concentration of higher than 1.0 mg/l, indicating the possible influence of anthropogenic activities. About 1.7% of samples had a nitrate-N concentration of higher than 10 mg/l. Results indicate nitrate contamination in groundwater was relatively low and stable in Alabama. Logistic regression analysis indicated that well depth, pH, and cropping activity were factors of statistical significance in influencing nitrate-N concentration in these wells. Factors such as septic tank use and livestock activities did not show a close link to nitrate-N concentration in wells tested.

Agriculture↗
PubMed2026

Metatranscriptomic analysis of viral sequences associated with Culex nigripalpus at an Alabama aquaculture site.

Mosquitoes associated with aquaculture habitats can harbor diverse viruses, yet the viromes of many locally abundant species remain poorly characterized. At an aquaculture-associated site in Auburn, Alabama, we surveyed mosquito populations and found Culex nigripalpus to be the dominant species collected. To characterize viruses associated with this mosquito, we performed RNA-seq on pooled female Cx. nigripalpus and compared complementary bioinformatic workflows for viral detection and genome recovery. One workflow removed host-associated reads by mapping to the closest available mosquito reference genome prior to assembly, whereas a second workflow used fully de novo assembly and viral database annotation. Additional protein-level filtering, cross-workflow comparison, and comparison of Trinity and rnaSPAdes assemblies were used to prioritize well-supported viral candidates. Across the original analyses, 16 submitted accessions corresponding to 12 collapsed virus/name groups were recovered, including Merida virus, Hubei mosquito virus 5, Zhejiang mosquito virus, Hubei virga-like virus 3, Rinkaby virus, Elemess virus, Qingnian mosquito virus, Serbia narna-like virus 2, XiangYun narna-levi-like virus 8, Ecclesville picorna-like virus, and baculovirus-like fragments. Several candidates were supported across multiple workflows, while others were recovered only under specific analytical conditions, indicating that candidate recovery was influenced by assembly and filtering choices. Selected viral contigs were independently supported by RT-PCR amplification. Overall, these results provide a first characterization of viral sequences associated with Cx. nigripalpus from an Alabama aquaculture-associated site and show that comparison across assembly and filtering strategies helped prioritize the most consistently supported viral candidates.

Animals↗
PubMed1996

The treatment of minor burns in rural Alabama emergency departments.

OBJECTIVE: The purposes of this descriptive survey were to determine the treatments for minor burns in rural Alabama emergency departments, to assess how closely those treatments correspond with recommendations for burn therapy noted in the literature, and to identify specific deficits in the burn research literature. DESIGN: A descriptive survey consisting of open-ended questions was used to gather data on current practices for treating outpatient burn wounds. METHODS: A researcher-developed questionnaire organized into seven categories of burn care was pilot-tested in an urban burn center; the questionnaire was then mailed to 96 rural Alabama hospitals, addressed to the ED nurse manager. The seven categories--initial cooling, analgesics, cleansing agents, topical antimicrobial therapy, wound dressings, blister debridement, and referrals--were identified from both major and minor burn care literature, because little research has been published about minor burns. Simple frequencies were used to analyze results from the 20% (n = 21) of the sample that responded. RESULTS: Seven categories of burn care are common to all respondent facilities, with wide variation in the details. Most practices proceed logically from the treatments recommended for major burn care, with a few notable and potentially dangerous exceptions, but there is no definitive research available to guide the clinician in the care of outpatient burns. Research questions were generated that can provide direction for measurement of outcomes in the care of minor burns treated on an outpatient basis.

Alabama↗
PubMed1997

Seroprevalence of Borrelia burgdorferi in dogs in Alabama, USA.

A random sample of private small-animal practices in Alabama submitted sera from dogs with known tick contact. A total of 579 samples from the three geographic regions of the state were collected (58% of the targeted sample size). Sera were screened for antibodies to Borrelia burgdorferi using an indirect fluorescent antibody (IFA) test which had a sensitivity and specificity of greater than 90%. Anti-B burgdorferi titers of > or = 1:64 were considered to be positive, based on results from B. burgdorferi-inoculated dogs. Ten of the 579 samples (1.7%) were positive, and titers ranged from 1:64 to 1:512. Seropositive dogs were found throughbout the state, and there was no significant difference in seroprevalence by region (Mantel-Haenszel chi 2, P = 0.85). These results indicate that the seroprevalence for canine Lyme disease in Alabama is low and that use of the canine Lyme disease vaccine is not justified.

Alabama↗
PubMed2002

Disparities in dental service utilization among Alabama Medicaid children.

OBJECTIVES: Access to oral health care and utilization of available services are important factors in minimizing the oral health disparities among underserved minorities. Our objective was to evaluate the racial and other factors related to 'realized access' to oral health care among Alabama Medicaid children. METHODS: Data were obtained from 308 538 Alabama Medicaid claims submitted in 1995-96 and analyzed using regression analyses. RESULTS: A lower proportion of Blacks (24%) and other racial groups (22%) compared to Whites (31%) and a lower proportion of 15-19-year-olds (15%) compared to younger age groups (30%) obtained dental services (P < 0.05). Odds of males obtaining care were slightly lower compared to females (OR = 0.96; 95% CI = 0.94-0.99). However, there was a significant interaction of race with other factors in determining service utilization. Subjects who were continuously eligible for Medicaid throughout the fiscal year were more likely to obtain care (OR = 2.86; 95% CI = 2.78-2.93). About one-fourth of the visits had an emergency procedure included in the treatment rendered. Availability of a participating dentist within the county of residence and the lower reimbursement-to-charge ratio were among the other related factors for underutilization of services. CONCLUSIONS: There is a significant racial disparity in utilization of dental services even among the Medicaid-eligible children. However, this was not a simple function of race, but a complex interaction of race with other factors such as age, gender, and location. ACKNOWLEDGMENT: Supported by CDC grant #U48/CCU 409679.

Adolescent↗
PubMedDate not supplied

An examination of population changes in Alabama's Black Belt counties: 1960-1970 and 1970-1980.

"Population changes in 11 Alabama Black Belt counties are examined by comparing annual average birth, death, and migration rates during the 1960s with those of the 1970s. The specific focus of the study is migration patterns among the nonwhite segment of the population. Data from the 1980 and earlier censuses are utilized, along with birth and death data from Alabama vital statistics reports." The results show "that net migration losses among nonwhites declined substantially during the 1970s compared with the 1960s and that in two Black Belt counties there was a reversal from heavy net losses to moderate net gains. Whites, on a county-to-county basis, however, were generally characterized by significantly higher rates of loss during the 1970s than in the 1960s."

Black or African American↗
PubMed2000

HIV risk and healthcare attitudes among detained adolescents in rural Alabama.

This qualitative study explored the dynamics of adolescent HIV risk through focus group interviews of male and female adolescents at an Alabama juvenile detention facility, key informant interviews, and through interviews of HIV-positive and -negative adults in institutional settings and public health clinics in Alabama. The interviews revealed that commodified or unprotected sex with multiple partners was a common risk activity for male and female adolescents, with a related high risk of sexually transmitted disease. The adolescents were aversive to condom use and lacked knowledge of the dynamics of HIV transmission. Bisexually behaving males who engaged in same-sex prostitution for money or drugs viewed female partners as the source of HIV infection. Illicit drug activity and risky sexual behavior were highly related to economic and status anxiety. Experiences of healthcare were often coercive or were undermined by negative perceptions of health professionals. These negative perceptions and avoidance or lack of access to healthcare compounded the already high risk of sexually transmitted disease for this group of adolescents.

Adolescent↗
PubMed1982

A comparison of prognostic factors and surgical results in 1,786 patients with localized (stage I) melanoma treated in Alabama, USA, and New South Wales, Australia.

Twelve clinical and pathologic parameters were compared in two series of Stage I melanoma patients treated at the University of Alabama in Birmingham, USA (676 patients) and at the University of Sydney in New South Wales, Australia (1,110 patients). Actuarial survival rates were virtually the same at the two institutions over a 25-year follow-up period. The incidence of thin melanomas (less than 0.76 mm) was also similar at both geographic locations (25% vs. 26%). Other similarities of these two patient populations included the following: 1) tumor thickness (Breslow Microstaging). 2) level of invasion (Clark Microstaging), 3) surgical results, 4) sex distribution, and 5) age distribution. The greatest differences between the two patient populations were their 1) anatomic distribution, 2) growth pattern, and 3) incidence of ulceration. The trunk was the most common site of melanoma, and occurred more frequently among Australian patients (37% vs. 28%). A multifactorial analysis (Cox's regression model) was then performed that included a comparison of the two institutions as a variable (Alabama vs. Australia). The dominant prognostic factors (p less than 0.0001) were 1) ulceration, 2) tumor thickness, 3) initial surgical management (wide excision +/- node dissection), 4) anatomic location, 5) pathologic stage (I vs. II), and 6) level of invasion. The benefit of elective lymph node dissection was demonstrated in both series for patients with intermediate thickness melanoma (0.76 to 3.99 mm.) For melanomas ranging from 0.76 to 1.5 mm in thickness, the benefit of node dissection was primarily in male patients. Survival rates for melanoma at the two institutions were not significantly different in the multifactorial analysis, even after adjusting for all other variable. Thus, the biologic behavior of melanoma in these two different parts of the world was virtually the same, with only minor differences that did not significantly influence survival rates. Long-term follow-up exceeding eight to ten years after surgery is critical in the interpretation of these prognostic factors and the surgical results.

Adult↗
PubMed1985

Practice location preferences of Alabama medical students.

Factors that help determine physicians' practice locations and specialties were listed by 396 students and 103 medical school faculty members at the University of Alabama School of Medicine. The students preferred practice locations similar in size to their hometowns. Their specialty choices were closely related to both practice location preferences and hometown sizes. However, there was a tendency among the students to prefer a small city (20,000 to 100,000 population) practice location irrespective of their hometown sizes or specialty choices. Factors such as spouse's preference, proximity of relatives, and financial incentives were not related to the students' practice location preferences. Faculty members reported they believed that medical education biases students toward urban and nonprimary care practice, and one-third of them said that they were role models for the students' specialty choices. However, the students said faculty members had little influence on their specialty choices while acknowledging the importance of clinical experiences. In general, Alabama medical students are similar to medical students elsewhere with respect to determinants of practice location preference.

Adult↗
PubMed1985

Vital statistics data as a measurement of perinatal regionalization in Alabama, 1970 and 1980.

Although regionalization of perinatal health care services has received credit for much of the recent improvement in neonatal mortality, until now no measurement of regionalization has been proposed. The measurement presented in this paper--the average of the percentage of infants of very low birthweight and neonatal deaths occurring among residents of a geographic area at a perinatal center--provides a means of comparing the extent of perinatal regionalization in various geographic areas and time periods. Despite continued disparities in the degree of regionalization from one perinatal district to another, Alabama's perinatal system became substantially regionalized from 1970 to 1980. The lower mortality for infants of very low birthweight born at a perinatal center suggests that if Alabama were more completely regionalized, its neonatal mortality would be improved.

Alabama↗