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Psychometric Evaluation Of A Perceived Barriers To Medication Adherence Instrument And Association Between Perceived Barriers And Patient Characteristics, Lynn Andreae Jan 2024

Psychometric Evaluation Of A Perceived Barriers To Medication Adherence Instrument And Association Between Perceived Barriers And Patient Characteristics, Lynn Andreae

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Medication adherence is an important component of diabetes management, yet nonadherence is common and has substantial patient and economic costs. In order to achieve meaningful improvements in medication adherence, clinicians and researchers need good ways of both identifying those at risk of nonadherence and ascertaining the specific reasons driving nonadherence in those patients. Current options for self-reported medication adherence are limited in their vulnerability to response bias, which may lead to overestimation of adherence. A measure that assesses perceived barriers to medication adherence may be a useful alternative, as it may identify patients at risk of nonadherence while reducing socially …


Examining Anti-Racist Attitudes In Maternity Care Workers, Angelina Aduke Toluhi Jan 2024

Examining Anti-Racist Attitudes In Maternity Care Workers, Angelina Aduke Toluhi

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Racism in maternity care has been identified as one of the major contributors to the persistent racial disparities in maternal health outcomes in the United States (US). Antiracism is a term used to describe the practice of actively identifying and opposing racism with the goal of changing policies, attitudes, behaviors, and beliefs that continue to foster racist ideas and actions. The results of this convergent mixed method research study reveal that racism and other forms of racial discrimination during maternity care may lead to adverse pregnancy outcomes in Non-Hispanic Black (NHB) pregnant patients in Southern US. In the first aim, …


Education Attainment And Health: Outside The Gender Binary, Brianna Patterson Jan 2024

Education Attainment And Health: Outside The Gender Binary, Brianna Patterson

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Transgender and gender nonbinary individuals, hereafter referred to as trans, report worse health outcomes than trans individuals whose gender identity matches their sex assigned at birth, hereafter referred to as cisgender (Bauer, Hammond, Travers et al. 2009, Cicero, Reisner, Merwin et al. 2020). Past research has indicated that social determinants of health, such as education attainment, may be responsible for these inequities (Low 2006, The Lancet Public 2020). Education’s influence on health is well known from previous research, but the association is not distributed equally. In the United States (US) educational system, state and local governments have control, not the …


Teachers' Perspectives On The Impact Of Interactive Read Aloud Strategies For Comprehension Skills Of Saudi Kindergarten Students: A Mixed Method Study, Riham Alsultan Jan 2024

Teachers' Perspectives On The Impact Of Interactive Read Aloud Strategies For Comprehension Skills Of Saudi Kindergarten Students: A Mixed Method Study, Riham Alsultan

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Reading comprehension is a very integral element of encouraging lifelong learning amongst kindergarten students. The main objective of this research is to investigate teachers’ perspectives on the effectiveness of interactive read-aloud (IRA) in improving reading comprehension skills amongst kindergarten students in Saudi Arabia. The study's overarching aim was to determine how interactive reading-aloud strategies employed by Saudi kindergarten teachers during interactive read-aloud time impact Saudi kindergarten students' overall comprehension skills through the perceptions of teachers regarding the effectiveness of these strategies. To achieve this objective, the researcher employed a mixed-method research design, a combination of both quantitative and qualitative strategies. …


Using The Social Ecological Model To Assess The Correlates Of Unprotected Sex Among African American Emerging Adults, Shirlacia S. Gray Jan 2024

Using The Social Ecological Model To Assess The Correlates Of Unprotected Sex Among African American Emerging Adults, Shirlacia S. Gray

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USING THE SOCIAL ECOLOGICAL MODEL TO ASSESS THE CORRELATES OF UNPROTECTED SEX AMONG AFRICAN AMERICAN EMERGING ADULTS SHIRLACIA S. GRAY DEVELOPMENTAL PSYCHOLOGY ABSTRACT Background: The Centers for Disease Control and Prevention (CDC) reported that HIV diagnoses for Black/African American men and women are 8x and 15x higher than white individuals, respectively. While the social determinants of health largely influence HIV transmission rates, reducing risky behaviors can lower the risk for HIV. This current study used the Social Ecological Model to investigate correlates of unprotected sex. Methods: Participants were recruited through respondent-driven sampling. Participant's demographics (age, gender, years of education, financial …


Understanding Disparities In Hypertension Treatment Cascade And Validating Blood Pressure Measurement Among Persons Living With Or At Risk For Hiv, Jessica Blair Jan 2024

Understanding Disparities In Hypertension Treatment Cascade And Validating Blood Pressure Measurement Among Persons Living With Or At Risk For Hiv, Jessica Blair

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In the United States, 44% of adult women >18 years have hypertension. Although non-Hispanic Black adults were more likely to be aware of and treated for hypertension compared to non-Hispanic White adults, Black individuals had the highest prevalence of uncontrolled hypertension. Persons living with HIV have a higher prevalence of hypertension, which is a major modifiable risk factor for cardiovascular disease. Similar to the geographic distribution of hypertension in the US, people living in the South have higher incidence of both hypertension and HIV diagnoses compared to other US regions. Furthermore, accurate diagnosis of hypertension and initiation of treatment is …


Trends In Reported Sexual Behaviors Among Alabama High School Students From 2011-2021, Sarah Franklin Jan 2024

Trends In Reported Sexual Behaviors Among Alabama High School Students From 2011-2021, Sarah Franklin

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Background: Sexual health education is associated with better outcomes among adolescents proper use of contraception, STI prevention methods, and lower rates of teenage pregnancy and STIs. In Alabama, sexual health education is not mandated in public schools. It is unknown how the lack of mandated sexual education has impacted trends in the sexual health of Alabama high school students. Methods: Using 2011-2021 data from the Youth Risk Behavior Survey (YRBS), this study evaluated trends in sexual behaviors, including: 1) sexual history, 2) current sexual activity, 3) risky or protective sexual behaviors, and 4) history of HIV testing, over time among …


Associations Of Religious Involvement And Cultural Justifications With Depressive Symptoms And Burden Among Caregivers, Maizonne Fields Jan 2024

Associations Of Religious Involvement And Cultural Justifications With Depressive Symptoms And Burden Among Caregivers, Maizonne Fields

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With the advancement of medicine, life expectancy has increased globally. As a result, the need for a caregiver by an older adult has also risen. A caregiver is often a spouse, child, or friend of an older adult that assists an older adult that is experiencing changes in their ability to complete activities of daily living and/or instrumental activities of daily living. Caregivers are often unpaid for their assistance and can be at heightened risk for negative mental health outcomes. This study used the Stress Process Model to investigate the associations of high levels of religious commitment or involvement (RCI) …


Examining U.S. National Trends In Adult Mental Illness And Naturalistic Psychedelic Drug Use, Daniel Grossman Jan 2024

Examining U.S. National Trends In Adult Mental Illness And Naturalistic Psychedelic Drug Use, Daniel Grossman

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Psychedelic drugs have gained prominent attention in recent years for their therapeutic potential in treating mental illness in clinical settings. Concurrently, population studies show increasing prevalence and notable demographic changes among naturalistic psychedelic users, as well as mixed associations between different types of naturalistic psychedelic use and mental health. However, despite this ongoing cultural shift, little is known about temporal changes in the mental health profiles of naturalistic psychedelic users at the population level. This thesis examined national trends in the association between past year naturalistic use of LSD, MDMA, and DMT/AMT/Foxy and past year mental illness among US adults, …


The Freshman Life And Student Health (Flash) Study: Using Social Network Analysis To Understand How Obesity And Stigma Impact Emerging Adult Health, Alena C. Borgatti Jan 2024

The Freshman Life And Student Health (Flash) Study: Using Social Network Analysis To Understand How Obesity And Stigma Impact Emerging Adult Health, Alena C. Borgatti

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Both racial discrimination and weight stigma have been identified as risk factors for poorer mental, physical, and social health. College students are vulnerable to the effects of stigma, as they greatly value peer acceptance and friendships during a pivotal time of emotional and health behavior development. The present study was the first to use social network analysis to examine the impact of weight and racial discrimination on the development of college social relationships and how these experiences influence students’ physical and mental health. 1330 participants (69% of on-campus freshmen) completed a brief survey on social networks, physical health, mental health, …


“Then Let Them Use Us Well”: How The Folger Edition Of Shakespeare’S Othello Limits Sexuality And Character Agency, Ann Elizabeth Mulherin Jan 2024

“Then Let Them Use Us Well”: How The Folger Edition Of Shakespeare’S Othello Limits Sexuality And Character Agency, Ann Elizabeth Mulherin

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Since Shakespeare’s first folio and quartos were initially published directly after his death in the early seventeenth century, various editors have altered his plays for their desired goals. With this in mind, the primary focus of my thesis centers around the Updated Folger edition of The Tragedy of Othello, the Moor of Venice, edited by Barbara Mowat and Paul Werstine, which was published in 2017. The Folger edition repeatedly points out that they have tailored their rendition of Othello to allow modern audiences to understand Shakespeare’s language; they present the intention to accurately and helpfully gloss confusing, antiquated, or significant …


Exploring The Associations Between Cognitive Training, Social Determinants Of Health, And Driving Behaviors: A Longitudinal Analysis Of The Active Study, Katie Wheeler Jan 2024

Exploring The Associations Between Cognitive Training, Social Determinants Of Health, And Driving Behaviors: A Longitudinal Analysis Of The Active Study, Katie Wheeler

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As the average lifespan increases, older adults are remaining independent into older ages than before. The ability to drive a vehicle is an essential part of daily living that helps older adults maintain independence. Cognitive training, specifically speed of processing training (SOPT), is an intervention that has consistently shown to benefit older adult’s driving abilities and driving behaviors. This dissertation examined the longitudinal association between cognitive training and primary driving location on crash risk across 20 years (Paper 1), investigated the effects of cognitive training and dosage on driving mobility across 10 years (Paper 2), and explored social determinants of …


Using Hope To Cope: Chronic Stress, Religious Coping, And Masked Hypertension In African American Adults: The Jackson Heart Study, Miriam Miles Jan 2024

Using Hope To Cope: Chronic Stress, Religious Coping, And Masked Hypertension In African American Adults: The Jackson Heart Study, Miriam Miles

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USING HOPE TO COPE: CHRONIC STRESS, RELIGIOUS COPING, AND MASKED HYPERTENSION IN AFRICAN AMERICAN ADULTS: THE JACKSON HEART STUDY ABSTRACT Chronic stress experienced at home or work has been associated with acute increases in blood pressure (BP) measured in the doctor’s office. Few data are available on the association of chronic stress with BP measured outside of the office setting. Religious coping, applying religious beliefs to adapt to stressful situations, and functional and structural social support may protect against MHT by promoting active coping behaviors and increasing emotional well-being. High levels of religious involvement and high social support have been …


Associations Between Grit, Life Satisfaction, And Academic Outcomes In Elementary And Middle School Students, Charles Jaylon Williams Jan 2024

Associations Between Grit, Life Satisfaction, And Academic Outcomes In Elementary And Middle School Students, Charles Jaylon Williams

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Grit is used to predict various positive benefits within students. Grit is trying to get back up to attempt another try at one’s goal after failure. Recently, grit has been seen as a potential candidate in improving the life satisfaction and academic performance of individuals. Grit is conceptualized as having two components, perseverance of effort and consistency of interest. Perseverance of effort is trying again until you finally accomplish your goal, while consistency of interest is a constant drive to complete one’s goals over a long-time span. This study measured the effects that grit has on elementary and middle school …


Investigating Impacts Of Caregiving On Cognitive Function: Role Of Social Support, Lu Tian Jan 2024

Investigating Impacts Of Caregiving On Cognitive Function: Role Of Social Support, Lu Tian

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Study Aim: Using the stress process model as a framework, this dissertation aims to investigate the role of social support on the influence of informal caregiving on cognitive function of caregivers aged 50 years and older and to look at potential gender and racial differences in this association. Method: Leveraging data from the 2016 to 2020 waves of the Health and Retirement Study (HRS), this research employs Ordinary Least Squares (OLS) regression analysis to examine the influence of caregiving on the cognitive function of older adults. To comprehensively understand the pathways through which caregiving impacts cognitive outcomes, I use mediation …


A Thematic Analysis Of Health Literacy And Education Disparities Regarding Medical Needs For Transgender Individuals, Rachel Mcmullen Jan 2024

A Thematic Analysis Of Health Literacy And Education Disparities Regarding Medical Needs For Transgender Individuals, Rachel Mcmullen

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Transgender individuals experience many challenges within the healthcare system including discrimination, socioeconomic struggles, financial strains, a lack of educated healthcare providers, and a health system framework that makes it even more challenging for them to receive their medical needs (Korpaisarn and Safer). One contributing factor to this lack of education is that on average medical schools in the United States only spend approximately five hours total on the health needs related to lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals (Miller et al.). Another contributing factor is the stigma around LGBTQ individuals within the medical community. The stigma is concerning …


The Association Between Cardiovascular Disease Risk And Fractures In Postmenopausal Women, Rafeka Hossain Jan 2024

The Association Between Cardiovascular Disease Risk And Fractures In Postmenopausal Women, Rafeka Hossain

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Background: Fragility fractures pose a significant healthcare and economic burden in the United States. While age and bone mineral density (BMD) are the primary established risk factors for fragility fractures, the relationship between cardiovascular disease (CVD) and fractures remains underexplored. The primary objective of this analysis was to estimate the association of CVD risk with fractures in postmenopausal women. Methods: Utilizing 30 years of data from the WHI, Atherosclerotic Cardiovascular Disease (ASCVD) risk scores were computed using baseline age, race, systolic blood pressure, total cholesterol, high-density lipoprotein, diabetes, anti-hypertension medications, and smoking. Fracture outcomes encompassed any clinical fracture, major osteoporotic …


Catecholamines And Catecholamine Resistance In Animal Models Of Metabolic Syndrome, Robert Follett Rosencrans Jan 2024

Catecholamines And Catecholamine Resistance In Animal Models Of Metabolic Syndrome, Robert Follett Rosencrans

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The sympathetic nervous system is a key regulator of energy homeostasis, in part, through the control of white adipose tissue lipolysis. Sympathetic nerves modulate adipose tissue physiology through the release of catecholamines, particularly norepinephrine, onto alpha- and beta-adrenergic receptors (a-AR; B-AR). Lipolysis refers to the breakdown of triglycerides into glycerol and free fatty acids, often in response to activation of B2/3-AR. Beta adrenergic activation of lipolysis is widely known to be impaired in patients with metabolic syndrome and animal models thereof (catecholamine resistance). Recent studies have demonstrated that catecholamine regulation of adipokine release is also disrupted, suggesting that catecholamine resistance …


Does Ceo Education Matter? The Relationship Between Doctoral-Educated Hospital Ceos And Organizational Performance, Kofi Ali Cash Jan 2024

Does Ceo Education Matter? The Relationship Between Doctoral-Educated Hospital Ceos And Organizational Performance, Kofi Ali Cash

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One of the most pressing issues in healthcare strategic leadership research is identifying which hospital chief executive officer (CEO) characteristics possess a significant and favorable relationship to organizational performance. However, little is known about the relationship between hospitals led by doctoral-educated CEOs and organizational performance. This study adds to our knowledge by examining the relationship between doctoral-educated hospital CEOs and selected financial and patient safety outcomes. UET served as the theoretical framework and guided the examination of the relationship between the selected dependent and independent variables. This study’s population included 509 acute-care hospitals across nine states, requiring a minimum four-year …


Shakespeare’S Tragic Heroines: Personality And Status Versus Gender, Ryann Grace Howard Jan 2024

Shakespeare’S Tragic Heroines: Personality And Status Versus Gender, Ryann Grace Howard

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Readings of Shakespeare’s female characters as presentations of ideals – such as innocence – or as characters limited by the innate nature of their gender fail to understand the full personalities and challenges these characters have. The chosen characters are discussed in the pairings of Cordelia and Cleopatra (queens) and Desdemona and Juliet (high-status ladies) to show how this thesis’s chosen female characters are presented through their individual statuses and personalities rather than their genders.


Comparison Of Radiological Signs To Clinical Symptoms In Children With Jia. A Pilot Study, Shubham Sharma Jan 2023

Comparison Of Radiological Signs To Clinical Symptoms In Children With Jia. A Pilot Study, Shubham Sharma

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JIA, which stands for juvenile idiopathic arthritis, is a group of chronic inflammatory joint diseases that usually occur in children under the age of 16 and last for at least six weeks1–5. It is one of the most common chronic joint diseases in childhood1 and affects up to 150 out of every 100,000 children worldwide6. This condition has no identifiable cause and is different from adult rheumatoid arthritis. Unfortunately, JIA can have a significant negative impact on the lives of these young children, causing disability and impairing their daily activities. TMJ involvement is more common than previously believed in JIA …


Spilling The Tea, Memoir Of A Future's Past: A Scholarly Personal Narrative, Dominique Jerome Hector Jan 2023

Spilling The Tea, Memoir Of A Future's Past: A Scholarly Personal Narrative, Dominique Jerome Hector

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Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) individuals and topics have been at the precipice of media coverage and policy decisions for decades. With the passage of same sex marriage by the Supreme Court in 2015, this ushered in a new era of unearthing narratives that are unique to LGBTQ+ identities. Although this is a huge advancement for this population here within the United States, scholars have posited how these identities intersecting with other social constructs such as race, gender, socioeconomic status, and social justice have reimaged how LGBTQ+ identities are viewed and treated in the country. Although there is …


An Examination Of The Relationship Between Mobile Apps And Healthcare Outcomes: A Patient Engagement And Patient Satisfaction Perspective, Khaled Hamad Alkhalifa Jan 2023

An Examination Of The Relationship Between Mobile Apps And Healthcare Outcomes: A Patient Engagement And Patient Satisfaction Perspective, Khaled Hamad Alkhalifa

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Background: Mobile apps are rapidly becoming an essential tool for hospitals to be competitive in a rapidly evolving healthcare market driven by patient expectations. The effectiveness of mobile apps is not fully understood, and more research needs to be done to evaluate their impact on patient satisfaction. More specifically, the role of patient engagement in this relationship needs to be investigated, given the rapid improvement in health behavior-changing mobile apps.Objective: This study aimed to examine (1) whether hospitals providing mobile apps are associated with higher patient satisfaction and patient engagement scores, (2) whether mobile app usability impacts this relationship, and …


I Would Be Shocked If Someone’S Not Depressed With That Diagnosis”: An In-Depth Exploration Of The Manifestation And Management Of Depression And Anxiety In Patients With Cancer, Carmen Rainey Brown Jan 2023

I Would Be Shocked If Someone’S Not Depressed With That Diagnosis”: An In-Depth Exploration Of The Manifestation And Management Of Depression And Anxiety In Patients With Cancer, Carmen Rainey Brown

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Patients diagnosed with cancer experience depression and anxiety at higher rates compared to the general population. Most individuals diagnosed with cancer will experience symptoms of depression and anxiety at some point during their cancer trajectory and not seek care leaving their mental health conditions undiagnosed and untreated, which impact quality of life and cancer outcomes. Patient and providers perspectives are vital to understand the manifestation, care-seeking behaviors, and provider management of depression and anxiety in patients with cancer. This study sought to explore the manifestation of depression and anxiety among patients with cancer and their care seeking behaviors for mental …


Unintended Pregnancy, Postpartum Contraception, And Healthcare Utilization Among Young Married Women Affected By Hiv In Kenya, Liza M. Kimbo Jan 2023

Unintended Pregnancy, Postpartum Contraception, And Healthcare Utilization Among Young Married Women Affected By Hiv In Kenya, Liza M. Kimbo

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Women with an unintended pregnancy are at risk of a repeat unintended pregnancy. Although use of postpartum contraception is an effective way to prevent repeat unintended pregnancies, the majority of unintended pregnancies globally occur in women who are not using contraception. Unintended pregnancies can have negative health and social consequences for both women and their children. This study aimed to better understand the use of postpartum contraceptives and healthcare services by married women with unintended versus intended pregnancy in south-western Kenya, with a special focus on young women. The study followed an exploratory sequential mixed methods design. In the first …


The Influence Of Proximity On Patient Outcomes For Differently Structured Ambulatory Surgery Centers, Wendy Michelle Smith Jan 2023

The Influence Of Proximity On Patient Outcomes For Differently Structured Ambulatory Surgery Centers, Wendy Michelle Smith

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THE INFLUENCE OF PROXIMITY ON PATIENT OUTCOMES FOR DIFFERENTLY STRUCTURED AMBULATORY SURGERY CENTERSWENDY SMITH HEALTH SERVICES ADMINISTRATION ABSTRACT This study examines the complication rates and patient-reported outcome measures (PROMs) for total hip and knee replacement surgeries conducted in one of two differently structured ambulatory surgical centers (ASCs) with varying interprofessional surgical teams. There is an ongoing shift from in-hospital total joint replacement surgeries to ASCs. Additionally, there is specialization occurring within ASCs. In this study, we compare single specialty ASCs designed to perform solely TJR surgeries with one orthopedic group and interprofessional team, with multi-specialty ASCs that perform an array …


Neuropeptide Y Overexpression In The Presence Of P23h Rhodopsin Mutation, Jean Sun Jan 2023

Neuropeptide Y Overexpression In The Presence Of P23h Rhodopsin Mutation, Jean Sun

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Neuropeptide Y (NPY), a 36-amino acid peptide, has been found to be the most abundant neuropeptide in the central nervous system, and it is widespread across mammalian species. NPY plays a dual role as a neurotransmitter and neuromodulator in the nervous system. NPY functions as a multifaceted neuromodulator through binding NPY receptors (NPYRs). NYP interacts with NPYRs and regulates various activities, such as cell growth, neurogenesis, neuroprotection, mitochondrial behaviors, food intake, anxiety, and addiction formation. In terms of NPY’s neuroprotective potential, NPY inhibits neuronal death signaling, thus preventing apoptosis, and displays anti-inflammatory and anti-oxidative effects. Additionally, it influences metabolism by …


Social Vulnerability And Trust Associated With African American Secondary Syphilis Cases Reported In Alabama, United States, 2020-2022, Givanta Tribit Jan 2023

Social Vulnerability And Trust Associated With African American Secondary Syphilis Cases Reported In Alabama, United States, 2020-2022, Givanta Tribit

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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 …


Functional Analysis Of Mandibular Movements In Three Different Groups Including Patients With Total Joint Replacements, Previous Orthognathic Surgery, And A Control Group, Adriana Morales Buendia Jan 2023

Functional Analysis Of Mandibular Movements In Three Different Groups Including Patients With Total Joint Replacements, Previous Orthognathic Surgery, And A Control Group, Adriana Morales Buendia

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Purpose: To Assess mandibular movements, including mouth opening, lateral excursion, and protrusion among patients with total joint replacements and orthognathic surgery compared to healthy control participants with no known TMJ disorders. Methods: Fifty-two subjects from 18 to 66 years of age were included in this cross-sectional study, distributed in three groups: patients with total joint replacement (n = 16), patients who underwent orthognathic surgery (n=17), and healthy control subjects (n = 19) to quantitatively determine whether there is statistically significant difference among the groups regarding opening, lateral excursion, and protrusion movements. The non-invasive system SiCAT JMT+ device was used to …


Comparing Three Resilience Frameworks Across Outcomes For Children Who Have Experienced Multiple Adverse Childhood Experiences, Kevin Keane Jan 2023

Comparing Three Resilience Frameworks Across Outcomes For Children Who Have Experienced Multiple Adverse Childhood Experiences, Kevin Keane

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Adverse childhood experiences (ACEs) have a well-established relationship with poorer mental health, health, and school-related outcomes among children. ACEs researchers have identified potential resilience frameworks like the National Scientific Council on the Developing Child (NSCDC), Health Outcomes from Positive Experiences (HOPE), and cumulative positive childhood experiences (PCEs) frameworks that identify protective factors to mitigate ACEs. However, each framework has a limited evidence base with no known studies comparing their effectiveness. The purpose of this dissertation was to compare the relationship between these three resilience frameworks and childhood outcomes in three domains (mental health, weight status, and school-related outcomes) among children …