Digital Commons Network^™

Dopamine-Dependent Transcriptional Dynamics In Striatal Physiology And Cocaine Reward, Morgan Elizabeth Zipperly

All ETDs from UAB

Exposure to drugs of abuse alters transcriptional programs and neuronal activity, leading to long-lasting cellular and behavioral adaptations that may contribute to addiction. The nucleus accumbens (NAc), part of the mesocorticolimbic dopamine pathway, plays a central role in motivation, reward, and reward-related learning, and this brain region is highly implicated in the development and maintenance of addiction. However, the specific contributions of defined cell populations in the NAc to drug reward processes is still poorly understood. Here, we used electrophysiological, optogenetic, and single-nucleus RNA-sequencing (snRNA-seq) approaches in a rodent model system to define the acute physiological and transcriptional responses of …

Disparities In End-Of-Life Care In Children Dying Of Cancer In Alabama: A Cross Sectional Study, Elizabeth Statham Davis

All ETDs from UAB

Regional studies show that children dying of cancer receive medically intense end-of-life care but there is limited information about end-of-life care in the Deep South and limited information about hospice and palliative care involvement at EOL. We conducted a retrospective electronic medical record review of children (0-x years) that died of cancer between 2010-20199 who received cancer directed therapy at Children’s of Alabama. We collected patient clinical and sociodemographics factors, including sex, race, and area deprivation index, cancer diagnosis and treatment, palliative care and hospice involvement, location of death, and medical care in the last 30d of life, including chemotherapy …

Diurnal Dysfunction In Control Of Sodium Excretion In Diet-Induced Obesity, Reham Soliman

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The renal endothelin system plays a key role in sodium excretion, particularly under high salt (HS) diet. HS stimulates renal endothelin-1 (ET-1), which binds and activates the endothelin receptor B (ETB) to excrete the excess salt. Loss of ETB receptor is linked to the development of hypertension under HS. Central clock genes are important in maintaining rhythmic patterns of sodium excretion and ET-1 is identified as a target for clock genes, including Period and Bmal1. ET-1 excretion follows a diurnal rhythm along with sodium excretion. Sexual dimorphism is evident in the diurnal regulation of endothelin-mediated natriuresis and its downstream targets. …

The Evolution Of Racism Through The Lens Of Lynching Rhetoric And Memory, Tammy Blue

All ETDs from UAB

The Evolution of Racism Through the Lens of Lynching Rhetoric and Memory, examines the use of ‘lynching’ in its definition, legislation and politics. Rhetoric has the power to influence and persuade, therefore when public figures manipulate lynching rhetoric, the meaning of lynching becomes distorted. In part, this thesis explores the difficulty of defining lynching. Among others, key players in this process included Walter White of the National Association for the Advancement of Colored People (NAACP), Monroe Work of the Tuskegee Institute, and Jessie Daniel Ames of the Association of Southern Women for the Prevention of Lynching (ASWPL). Their battle to …

Translating Public Health Strategies To Examine Hypertensive Disorders Of Pregnancy In Alabama, Matthew Dean Moore

All ETDs from UAB

Hypertensive disorders of pregnancy (HDP) are on the rise in the United States and contribute significantly to maternal and infant morbidity and mortality. The impact of such disorders is especially burdensome for women insured by Medicaid, for those who live in the South, and for those representing racial and ethnic minorities. It is evident across the aims of this dissertation that HDP remains an important public health concern to stakeholders in Alabama, its diagnosis is influenced by various maternal characteristics, and it can result in disparate severe outcomes for some populations. The first aim examines systems level decision-making in the …

Assessment Of Neuropsychological Outcomes After Traumatic Brain Injury And Association With Early Orientation Performance, Christina Diblasio

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Moderate-severe traumatic brain injury (TBI) is a leading cause of permanent disability, and cognition plays a critical role in overall function and life after TBI. Moderate-severe TBI often creates long-term deficits in the domains of attention, processing speed, memory, and executive function. Given the prevalence of cognitive deficits following injury and the debilitating effects these deficits can have on functioning, it is important to monitor cognition directly following injury and across recovery. Routine cognitive assessment is essential in order to identify deficits, track recovery, and better guide rehabilitation and educational efforts. It is also critical to identify accurate and feasible …

Lily's "Undercurrent Of Thought": Searching For Agency Through Emotion And Affectation In The House Of Mirth, Rebecca Foushee

All ETDs from UAB

On the surface, Edith Wharton’s breakout novel, The House of Mirth (1905), and its main character, Lily Bart, appear to exhibit the inferior role women hold in the Old New York society of Wharton’s youth. However, a close reading reveals Lily consciously alters her appearance throughout the novel as she searches for social power. This article examines the divide between Lily’s external performance and her inner emotions as she attempts to gain the economic stability she is trained to desire. Drawing on Melanie Dawson’s Emotional Reinventions, this article discusses Lily’s fluctuating emotions and the way they influence how Lily chooses …

There And Back Again: A Rhetorical Journey From Oppression To Exclusion, Sally Anne Perz

All ETDs from UAB

This thesis addresses parallels between the rhetoric of contemporary secessionists and the arguments surrounding the rise and fall of Jim Crow laws which maintained segregation for decades. Cities like Gardendale, Alabama and Baton Rouge, Louisiana make uncanny arguments in their attempts to break-away from county school systems, promoting new and improved propaganda, alluding to “separate but equal” in their attempts to separate for the good of their communities. Despite years of multicultural instruction, schools are fighting the same battle, on the same turf, generations later—some cities surrounding Birmingham and across the country add a new twist on the same white …

"Autism Friendly Alabama": Identifying Key Criteria To Support An Inclusive Environment, Caro C. Wolfner

All ETDs from UAB

The present study examined potential supports and barriers towards an inclusive or ‘autism friendly’ environment from the perspectives of family members of individuals with ASD (n=127) and adults with ASD (n=16). Groups did not differ on endorsement of importance for any of the criterion, except for crowds (p<0.05). The highest ranked quality by Caregivers/Family members were knowledgeable and helpful staff’ (32.5 percent) and attitudes (22.5 percent). The ASD group ranked knowledgeable and helpful staff (30 percent) and crowds (30 percent) as the most important quality. Qualitative data showed that modulated sensory environment, knowledgeable and trained staff’; access to supports, and awareness of locations & as emerging themes for ‘autism friendly’ environments. The present study represents an approach involving research, education and advocacy to provide evidence-based criteria that will be used as a standard for ASA’s Autism Friendly Alabama program. With criteria identified, stakeholders can move forward with completing subsequent goals for the initiative, such as program implementation and evaluation.

Nutrition Transition And Ses As A Fundamental Cause: An Integrative Approach To Examine Weight Status Among Women In Nepal, Sanjeev Acharya

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The increasing prevalence of overweight and obesity in developing countries is a public health problem. Globally and in Nepal, women have higher burden of overweight and obesity. Over the recent years, Nepal has made progress in human development and is also experiencing nutrition transition. In this context, the goal of this study is to investigate the change in association between socioeconomic status (SES) and body weight over time, examine whether SES – body mass index (BMI) varies across region and occupation, and test for the double burden of malnutrition among adult women. Using a novel framework that integrates nutrition transition …

Neural And Neuropsychological Correlates Of Driving In Autism And Attention-Deficit/Hyperactivity Disorder, Haley Bednarz

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Individuals with autism spectrum disorder (ASD) and with attention- deficit/hyperactivity disorder (ADHD) commonly exhibit difficulty with driving. Understanding the neuropsychological factors that contribute to driving difficulty can inform designing effective training programs for these groups. The overarching goal of the current project was to examine how core sociocognitive deficits of ASD and of ADHD (specifically executive functioning (EF) and theory of mind (ToM)) relate to driving behavior among licensed drivers. To comprehensively investigate this question, we employed a multipronged approach involving three modalities of measurement: 1) driving performance in a driving simulator, 2) comprehensive neuropsychological assessment, and 3) neural response …

Novel Methods For Establishing The Capacity For Nociception And Cognition In The Zebrafish Danio Rerio, Chris Taylor

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Here we demonstrate the utility of a zebrafish-based model of nociception to serve as a novel screening tool for analgesic drugs. Zebrafish swimming behavior was measured following administration of various algogens used in rodent research. All compounds reduce distance traveled, thought to be an expression of nociception. Furthermore, we undertook to investigate the contribution of sex and feeding history on the acetic acid-evoked nociceptive response in zebrafish. Data suggest that male fish were more sensitive to pain than females, and that females recovered from pain faster than males. Dietary restriction increased pain sensitivity in zebrafish. We then tested the viability …

Contribution Of Adaptive Immune Responses In Chronic Lung Diseases, Thi Kim Tran-Nguyen

All ETDs from UAB

Immune dysregulation is a hallmark of various chronic lung diseases such as Chronic Obstructive Pulmonary Diseases (COPD) and Idiopathic Pulmonary Fibrosis (IPF). Previous studies in our lab have shown evidences of autoimmunity such as increases in autoantibodies, abnormal T cell profile, immune complex deposition and the presence of ectopic lymphoid structures in the lung of these patients. This thesis consolidates two separate projects about various aberrant immune responses in these diseases. The first project identified Glucose-Regulated-Protein 78 (GRP78) as the common autoantigen in COPD and characterized how GRP78 autoantibodies may increase COPD mortality via its atherogenic effects. I demonstrated that …

Role Of Trib3 In Progression And Pathogenesis Of Diabetic Retinopathy, Priyamvada Milind Pitale

All ETDs from UAB

Diabetic retinopathy (DR) is reported to be one of the leading causes of blindness in the United States by Center for Disease Prevention and Control. As the estimated prevalence of the disease will likely triple by 2020, the research in this area should focus on identifying novel targets and therapeutic approaches. One of the therapeutic approaches for DR is the reprograming of retinal metabolism to delay the progression of the disease. The unfolded protein response (UPR) is recognized as a cellular pathway activated in diabetic retina which interacts with key transcription factors to physiologically regulate glucose, lipid homeostasis, and angiogenic …

Suicidality, Stigma, And Online Help-Seeking, Mercedes Tarasovich

All ETDs from UAB

Suicide rates in the U.S. have been climbing for over two decades, driving increased suicide prevention efforts nationwide. The population of those who have experienced suicidality or attempted suicide are estimated to be at least 25 times the suicide death rate and are not as well-researched. Stigma regarding the utilization of mental health care services and a fear of institutionalization may affect help-seeking behaviors for individuals who have experienced suicidality, potentially prompting use of more anonymous online sources of support. In this study, I aimed to research whether suicidality and perceived mental health stigma can lead to increased use of …

Characterization Of Intraocular Pressure Fluctuations, Intracranial Pressure And Translaminar Pressure Measured With Wireless Telemetry In Nonhuman Primates, Jessica Violet Jasien

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Glaucoma is the second leading cause of blindness and third leading cause of visual impairment worldwide; 180 million people suffer from a glaucomatous visual disability. Glaucoma is an ocular neurodegenerative disease with several risk factors. The major identified risk factors of glaucoma are intraocular pressure (IOP), age, race, central cornea thickness, family history, and low diastolic blood pressure. The lowering of IOP is the only modifiable risk factor for the disease. However, we know little about the true character of IOP. Periodic IOP measurements are obtained every few months or at the discretion of the clinician during office hours and …

The Impact Of Time-To-Collision Estimates On Transportation Safety For Young Drivers With Developmental Disabilities, Austin M. Svancara

All ETDs from UAB

Motor vehicle collisions (MVC) are the leading cause of death for young drivers. MVC risk is higher among drivers with developmental disabilities, particularly individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). Difficulties in time perception may negatively impact driving, such as with time-to-collision (TTC) estimations (i.e., an estimation of how long it will take to collide with another vehicle). The goal of this study was to determine whether individuals with ADHD and ASD displayed decrements in TTC estimations and whether perception of time in a general context was related to TTC estimations in a driving-specific context. A total …

The Relationship Between Government Grants And Nonprofit Revenue Diversification, Samantha Jeanne Arceneaux

All ETDs from UAB

The financial health of nonprofits has been of interest to researchers for decades and continues to be of concern as the size United States nonprofit sector continues to grow both in the number of registered nonprofits and in finances, and third-party government increasingly uses partnerships with nonprofits to deliver services to the public. Empirical studies of revenue diversification and concentration indicate that they can both contribute to nonprofit financial health by assisting in developing a strategy of financial sustainability or financial capacity. However, empirical studies on the relationship between government funding and the nonprofit sector have been limited. This analysis …

Counter Narratives Of Black Female Educators In Exurban Schools, Monisha Douglas Moore

All ETDs from UAB

This study explored how three Black female educators characterized their personal narratives regarding their teaching experiences. Guided by a social justice framework, this study attempted to show how Black women’s identities have been co-created, how their perceptions of success have been formulated, and how perceptions of academic success have helped them frame their pedagogy for diverse students. Because limited research has examined how Black female educators in exurban areas situated their perceptions and pedagogy to facilitate the needs of diverse students, this study added to the limited knowledge. Purposeful sampling was conducted at the site and participant level. The research …

Smoke Inhalation, Lung Function, And Heart Rate In Wildland Firefighters, Jordan E. Nelson

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Given the close proximity to the fire front and limited use of respiratory protection, wildland firefighters are exposed to elevated levels of biomass smoke during regular occupational shifts. Due to the complex composition of biomass smoke, the relationships relating biomass smoke exposure to health outcomes has yet to be elucidated. In addition to occupational exposures, increasing intensity of wildfire events may place communities within close proximity to wildfires at risk of biomass smoke exposure. This study aimed to assess exposures to biomass smoke particles and quantify respiratory and cardiovascular health responses during active fire events using novel monitoring techniques. Personal …

Developing High School Students' Historical Empathy Skills Using Historical Dialogues: A Qualitative Study, Nefertari Yancie

All ETDs from UAB

This qualitative case study explored how perspective writing, in the form of historical dialogues, had the potential to help high school students in an urban school develop historical empathy skills. The study took place in an 11th grade United States history class where three types of data, interviews with the teacher, observation field notes, and student work, were collected over one school semester. Findings indicate that when presented with counter-narratives that introduce the experiences of groups that have been historically marginalized through U.S. history, students are more easily able to make personal connections and empathize with people from the past. …

Understanding Financial Hardship In Women With Breast Cancer, Courtney Williams

All ETDs from UAB

Individuals with cancer are at risk of material, psychological, and behavioral financial hardship due to costly new treatments, increasing time on treatment, and longer survival. Breast cancer is an ideal environment to study financial hardship. Treatment options for metastatic breast cancer are heterogeneous due to differences in patient characteristics, disease biology, and because it has the largest number of treatment options of any metastatic cancer. In early stage breast cancer, treatment options include multimodality treatments, including surgery, radiation, and medical therapy (chemotherapy, hormone therapy, targeted therapy), with the choice for each modality being dependent on the other modality decisions. Despite …

The Comparison Of Two Diabetes Self-Management Education Programs In The Reduction Of Patient A1c Levels, Edward Sharpless

All ETDs from UAB

This dissertation was a quasi-experimental research study exploring the effectiveness of two educational teaching methods with patients with diabetes. One teaching method utilized an education framework called the Conversation Map tools, a group-based, highly interactive learning experience using colorful visual tools, activity cards and sharing of real-life experiences. The other method was a traditional, lecture-style class taught by a health educator using overhead slides and handouts.

Secondary data from a regional health system in the Western U.S. was used to test the hypothesis that participants in the Conversation Map classes would report a larger drop in A1c levels compared to …

Fixed And Variable Costs At Critical Access Hospitals, Jeremy J. Lyman

All ETDs from UAB

Cost structures (the ratio of fixed to variable costs) vary across and within indus-tries. Hospital managers and policymakers can make better decisions when they under-stand cost structures, including marginal costs (the change in the total cost that arises when the quantity produced is increased by one unit). Although some studies have inves-tigated hospital cost structures, the results have been mixed and less than definitive, and very little attention has been given to critical access hospitals and marginal costs specifi-cally. Rural hospitals, including critical access hospitals, have increasingly experienced financial distress. Between 2005 and 2019, 159 rural hospitals closed across the …

Hospital Charge And Ricing Transparency, Kunal N. Patel

All ETDs from UAB

Hospital pricing is not uniformly disclosed to patients up-front before the delivery of healthcare. Moreover, pricing is not commonly understood by consumers and researchers, because the information was largely unavailable due to the lack of a federal policy mandate to make the information publicly available up until recently. The federal government instituted a series of regulations that initially began to take effect in 2019 in order to increase hospital pricing transparency with the aim of bending the healthcare cost curve. In this dissertation, hospital response, hospital standard charge variation, and healthcare management and policy expert opinion surrounding the implementation of …

Challenges And Promising Strategies For Maximizing Pregnant Women's Adherence And Retention In Niv Care In The Context Of Option B+ In Kenya, Anna Helova

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Under the current Kenyan guidelines, pregnant/postpartum women who test HIV-positive are immediately put on the lifelong antiretroviral (ART) therapy (Option B+) and are initiated into the prevention of mother-to-child (PMTCT) protocol. Gaps at each step of the PMTCT continuum undermine the positive impact of lifelong ART. Challenges at the individual, interpersonal, community, and health facility-levels contribute to these gaps. A community-based mentor mother (cMM) program tested under the Mother-Infant Visit Adherence and Treatment Engagement(MOTIVATE!) Trial (NICHD R01 R01HD080477; ClinicalTrials.gov#14-0331) is a potential approach to address these challenges. The three manuscripts comprising this dissertation used qualitative and quantitative methods with the …

Impact Of Ncqa Pcmh-Level On Low Income Diabetics In Louisiana, Michael G. Griffin

All ETDs from UAB

While past studies have examined the relationship between safety-net provider sites that are certified as Patient Centered Medical Homes (PCMH) and quality health care outcomes, no previous studies have evaluated the relationship between NCQA PCMH certification levels at primary care sites and quality health care outcomes. NCQA is the largest national certification program for PCMH, and for 10 years was the only national program that offered a tiered level of certification based on provider level of patient engagement and deployed resources. The Donabedian Model, which focuses on structure, process, and outcomes, was used to develop the theoretical framework to address …

The Luckiest Girl In The World: A Texan Seeks Her Birth Parents, Ardell Taylor Fleeson

All ETDs from UAB

This creative nonfiction thesis combines memoir with documentary research to tell the story of the adoptive parents of the author, and the author’s successful search for her birth parents. The adoptive mother’s story starts and finishes the narrative, spanning fifty-five years of her life, from her rise from poverty to prosperity in mid-20th century Texas. The middle of the article is the author’s discovery of her birth parents, the key event for which is the Texas court’s unsealing the author’s adoption file. Names and dates empowered the author to find four half-siblings and speak with her birth mother on the …

Trajectories Of Teen Driver Self-Regulation: Role Of Learner Phase Practice And Executive Function, Melanie Grace Albright

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Motor vehicle collisions (MVCs) continue to claim the lives of many teen drivers each year in the United States despite significant prevention efforts, and the primary contributor to these MVCs is driver behavior. Previous research suggests practice driving in diverse environments during the pre-licensure phase is related to better driving outcomes post-licensure, including a reduced risk of MVCs, especially in the first year of independent driving when teens are at a higher crash risk. The pre-licensure and initial licensure phase typically co-occurs with rapid executive function (EF) development, which may be important for successfully managing the driving task. However, the …

Effects Of Acculturation On Stigma And Knowledge In Relation To Autism Spectrum Disorder Amongst Latino Populations, Monica M. Abdul-Chani

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In the United States, Latino children receive autism diagnoses at a later age compared to non-Latino Black and non-Latino White children (Jo et al., 2015), have the highest rate of misdiagnosis (Magaña, Lopez, Aguinaga, & Morton, 2013), and are more likely to be under-identified (Pedersen et al., 2012). This study examines the presentation of ASD stigma and potentially influencing factors in Latino populations. Through an online survey, 97 Latino and 115 non-Latino White participants were randomly assigned to read one of two vignettes depicting characteristics and symptoms of ASD in lay terms for either their own child (self) or a …