Digital Commons Network^™

Analysis Of Excess Mortality At The County Level In Alabama By Socioeconomic Factors, Abigail Jo Tucker

All ETDs from UAB

Objective: Analyze county level socioeconomic factors and their association with Covid-19 excess mortality in Alabama.Methods: Linear regression analyses were used to evaluate the association between potential risk factors assessed using the American Community survey (n = 40 counties and county clusters) and excess mortality in 2020 per 100,000 population. Excess mortality came from a previously published paper by Ackley et al. Results: Median household income (per 1,000 dollars); an average county median household income that 1,000 dollars higher was associated with 6 per 100,000 lower excess mortality (β= -5.953 p-value

Telehealth High-Intensity Interval Exercise And Cardiometabolic Health In Spinal Cord Injury, Jacob Adams

All ETDs from UAB

BACKGROUND: Recent studies have shown that high intensity interval training (HIIT) can improve cardiometabolic health in individuals with spinal cord injury (SCI). Individuals with SCI experience a wide array of barriers to participate in exercise such as lack of time, accessible equipment, and transportation. It is imperative to identify modes of exercise that provide effective health benefits and are accessible while requiring low time commitment. Studies have demonstrated that HIIT has similar positive improvements in cardiometabolic health with 20% of total time commitment compared to moderate intensity exercise (MIT) in short term studies. OBJECTIVES: The purpose of this study is …

Developing Criteria For The Provision Of Alabama Service Assistance Program (Asap) Service, Charles Nwachukwu Agusiobo

All ETDs from UAB

The Alabama Department of Transportation’s (ALDOTs) Alabama Service Assistance Program (ASAP) helps facilitate the safe and efficient movement of people and goods by providing Safety Service Patrols (SSP) along major interstates in Alabama and utilizing effective incident management strategies to minimize the impacts of freeway incidents. Efficient operation of ASAP improves timely emergency response, increases operational efficiency of the transportation facilities, improves user satisfaction, and results in safety benefits including prevention of secondary crashes. This study focused on developing a new methodology that can determine with greater efficiency when and where ASAP services are needed. The proposed methodology can replace …

A Gastrointestinal-Specific Antibiotic As An Experimental Treatment For Anxio-Depressive Disorders, Yuang-Tai Huang

All ETDs from UAB

Chronic stress is a predisposing factor for various disease states, including neuropsychiatric disorders, such as depression and anxiety [1]. Stress-related disorders have complicated multifactorial etiologies [2]. Advances in psychotherapeutic and psychotropic treatments have occurred, but anxiety and depressive disorders are still prevalent and remain a burden to our societies [3]. More than 30% of major depressive disorder patients fail to remission despite an FDAapproved medication [4]. Meanwhile, the contribution of microbiota-gut-brain axis signaling in both etiologies and treatment of stress-related disorders is increasingly being recognized [5]. More evidence has shown that the gut microbiota has the potential to alter the …

Adaptive Functioning And Academic Achievement In Survivors Of Childhood Acute Lymphoblastic Leukemia: Associations With Executive Functioning And Socioeconomic Status, Victoria C. Seghatol-Eslami

All ETDs from UAB

This study examined the associations of functional outcomes (adaptive functioning and academic achievement) with executive functioning and neighborhood-specific variables (area deprivation and child opportunity) and individualized education plan (IEP) support in survivors of childhood acute lymphoblastic leukemia (ALL). From a retrospective database, 44 patients (38.6% female, 72.7% non-Hispanic White, ages 6-17) previously diagnosed with low-risk or standard-risk pre-B cell ALL and treated with chemotherapy-only were identified. Participants were evaluated on performance-based measures of executive functioning and academic achievement, and parent-ratings of executive and adaptive functioning. Within adaptive functioning, 45.5% of patients showed impairment (≥ 1 SD above the normative mean) …

"The Cloak Of Social Feeling": Alfred Adler's Gemeinschaftsgefuhl In Practice And Memory, Esteban T. Arnold

All ETDs from UAB

This thesis provides a comprehensive overview of the evolution of Alfred Adler’s concept of Gemeinschaftsgefühl (community feeling), a simple yet potent idea that started in a Viennese café and expanded far beyond it. Ideas have lives beyond that of their authors, and this thesis argues that Alfred Adler’s idea of Gemeinschaftsgefühl was pressed into the service of various social and political agendas. Adler was privately a socialist, but he never wished to see Gemeinschaftsgefühl become a tool for this or any other movement. With an idealistic worldview, Adler sought to challenge and transform the pervading medical and psychotherapeutic conceptions of …

Adverse Childhood Experiences: Connecting The Dots Between Early Life Stress And Asthma Aming Children And Adolescents With Sickle Cell Disease, Brandi Mcclain Pernell

All ETDs from UAB

Sickle cell disease (SCD) is an inherited red blood cell disorder plagued by increased morbidity and premature mortality. Asthma disproportionally affects individuals with SCD and is strongly associated with an increased incidence of pain, acute lung complications and death among this high-risk population. Psychological stress is a well-established contributor and trigger for asthma development and exacerbations. Adverse Childhood Experiences (ACEs) are defined as traumatic experiences occurring before 18 years of age. ACEs occur at the individual, familial (Original-ACEs) and community level (Expanded-ACEs) and can accumulate with time. Chronic exposure to ACEs leads to toxic stress, widespread inflammation and risk for …

Characterizing Occupational Status History And Assessing Occupational Status As A Social Determinant Of Health In The Deceased Organ Donor Population, Nicole F. Pelletier

All ETDs from UAB

Transplant physicians review clinical data ranging from laboratory values to substance use history and use prediction models combining these factors, along with previous recipient outcomes, to evaluate deceased organ donors for organ suitability. Factors such as social determinants of health (SDOH) are not currently included in prediction models, despite evidence of relationships between SDOH and health outcomes in the general population. Occupational status is a SDOH routinely collected at the time of donation and stored in DonorNet, but not yet characterized in the deceased donor population. Despite well-documented relationships between occupational status and health outcomes in the general population, these …

Adolescent Alcohol, Tobacco, And Marijuana Use And Dma Methylation In Young Adulthood, Kristina Brooke Mcmahan

All ETDs from UAB

Substance use, including the use of tobacco, alcohol, marijuana, and other drugs, is most likely to begin during adolescence or emerging adulthood. Substance use during these developmental periods has been linked with a number of negative physical, mental, and cognitive health outcomes. Some of these long-term negative effects of substance use during adolescence and emerging adulthood may be explained by epigenetic changes through a process called DNA methylation. However, much of the research on substance use and DNA methylation has focused on prenatal drug exposure and its relationship to differential methylation profiles during childhood and young adulthood. By contrast, little …

Development Of A Fit-Matching App: Validation Of 3-D Scanning Applications, Jasna Rosser Williams

All ETDs from UAB

According to the National Institute of Occupational Health and Safety (NIOSH), each day nearly 2,000 workers sustain a job-related eye injury that requires medical treatment. It has been reported that the cause of these eye injuries is frequently due to workers not wearing eye protection because it does not fit properly on their faces. To improve the fit of eye protection, we are aiming to develop a fit matching application (app) which will identify the wearers’ better-fitting safety eyewear using 3D technology. We have successfully tested the feasibility of the use of commercially available 3D scanning apps using a mannequin …

Early Detection Of Acute Kidney Injury In Neonates After Cardiopulmonary Bypass, Tennille N. Webb

All ETDs from UAB

Prophylactic peritoneal dialysis (PD) in neonates undergoing cardiac surgery with cardiopulmonary bypass (CPB) has proven to be safe and improve outcomes. Understanding which neonates would most benefit from prophylactic PD is needed to optimize care. Objective: We sought to validate patient-specific characteristics associated with the need for PD in neonates requiring CPB. We hypothesized serum creatinine (SCr), pre-operative weight, or open chest post-operatively are associated with the need for PD. Methods: We evaluated neonates in the cardiac ICU requiring cardiac surgery with CPB from March 2019 through March 2021 with our new protocol for PD catheter placement. Neonates were classified …

The Effects Of Near Field Magnetic Induction Monitoring Of Health Care Workers' Hand Hygiene Compliance, Thomas H. Ozburn

All ETDs from UAB

Hospital Acquired Infections (HAIs) are among the top five leading causes of death in the United States (Scott, 2009). Estimates of the annual direct medical costs of HAIs to U.S. hospitals have ranged from $28,400,000,000 to $33,800,000,000 (Scott, 2009). Many leading health care organizations have agreed that there is a link between infection prevention and the spread of HAIs (Allegranzi, 2009). This study explored health care workers’ hand hygiene compliance and whether automated compliance reporting improved compliance. A new system powered by technology called Near Field Magnetic Induction (NFMI) found a significant increase in compliance upon introduction of an automated …

An Examination Of The Relationship Between The Role Of The Chief Diversity Officer And Hospital Financial Performance And Patient Experience Measures, Kemberly L. Blackledge

All ETDs from UAB

Healthcare organizations drive to achieve hospital measures has much to do with strategies put in place by the executive leadership team and resources of the firm. Forces such as regulatory changes reducing hospital payments and external forces such as social injustices leave executives turning to innovative ways to improve the bottomline. This study examined the Chief Diversity Officer (CDO) and the relationship with hospitals measures of financial performance and patient experience for hospitals with a CDO and without a CDO. Hospitals with a CDO can deploy organizational strategies such as diversity management and cultural competencies. These strategies are important because …

The Effects Of Charity Hospital Privitization And Medicaid Expansion On Medicaid Patient Emergency Department Utilization In Louisiana, Sean M. Prados

All ETDs from UAB

Two significant events transpired in Louisiana that had sweeping changes for the healthcare system between 2013 and 2016: (1) the privatization of the nation's only stateowned Charity Hospital System via cooperative endeavor agreements with local, private hospitals known as public-private-partnerships (PPP), and (2) the implementation of Medicaid expansion, referred to as implementation of the Affordable Care Act (ACA). Either event independently could have had significant utilization and financial implications for hospitals. This retrospective, quasi-experimental research implemented a generalized estimating equation (GEE) analysis to examine the effects of PPP and ACA on Medicaid patient emergency department utilization by PPP hospital designation, …

Grainyhead-Like 2 (Grhl2) Has Anti-Oncogenic Potential In Glioblastoma, Rachel M. Carnes

All ETDs from UAB

Grainyhead-like 2 (GRHL2) is a complex transcription factor associated with roles in both development and cancer. In development, GRHL2 suppresses a series of genes associated with the mesenchymal phenotype, while actively promoting the expression of genes associated with the epithelial phenotype. Due to this GRHL2 is considered a main gatekeeper of the epithelial to mesenchymal transition (EMT), playing a crucial role in epithelial morphogenesis and neural tube closure. These basic traits for GRHL2 have also been found to be similar in cancer. GRHL2 has multi-faceted functions in cancer, in which it can be considered either an oncogene or a tumor …

The Role Of Dock3 In Normal Skeletal Muscle Function And Metabolism, Adrienne Samani

All ETDs from UAB

DOCK (dedicator of cytokinesis) are proteins of an 11-member family of typical guanine exchange factors (GEFs) expressed almost exclusively in the brain and spinal cord. Human pathogenic DOCK3 variants have been identified to cause debilitating neuromuscular phenotypes such as muscle hypotonia, ataxia, and intellectual disability. Our lab identified DOCK3 as being strongly upregulated in Duchene muscular dystrophy (DMD), specifically in the skeletal muscles of DMD patient and mouse skeletal muscles. Global Dock3 KO mice on the dystrophin-deficient background exacerbated skeletal muscle and cardiac phenotypes. Similarly, DOCK3 KO mice appeared to have poor muscle architecture, locomotive activity, reduced myogenic fusion, impaired …

The Role Between Transactive Memory Systems In The Relationship Between Psychological Safety & Quality In Interprofessional Healthcare Teams, Tera L. Webb

All ETDs from UAB

During uncertainty, the optimum solution for work-related problems or patient care cases require the scopes of practice and competencies beyond a single profession. For this reason, the collaborative efforts of interprofessional teams are a widely used approach to patient care and medical decision making. The interdependency between healthcare professionals with varied expertise and input often lead to desired outcomes. Beyond the structure of the team, there are numerous cognitive processes at play that impact knowledge transfer in highly skilled teams that impact outcomes. Therefore, this dissertation will review relevant literature on two cognitive constructs – psychological safety and transactive memory …

Instructional Leadership During Modern Crises: A Phenomenological Study Of A Pandemic In The Modern Age, Larry Bradley Robertson

All ETDs from UAB

Significant research exists concerning crisis management in schools; however, educational leaders were unprepared for the COVID-19 pandemic (Bratianu & Bejinaru, 2021; Diliberti et al., 2020; Tomasik et al., 2020). This crisis was different from any experienced in modern times. It impacted the entire world in terms of politics, economics, education, and way of life. New issues emerged due to the necessity for schools to implement remote learning. Among those issues were online learning, the disparity of the haves and have nots among students, social and emotional well-being of students, learning loss, and the role of the educator (Martinez & Broemmel, …

"Bricks Without Straw": An Oral History Of Culturally Relevant Caring In Historic A.H. Parker High School In Birmingham Alabama, Penny S. Seals

All ETDs from UAB

Industrial High School, later renamed A.H. Parker High School after the inaugural principal, Arthur Harold Parker, is a predominantly African American high school located in Birmingham, Alabama. In 1900, A.H. Parker High School was established as the first four-year public high school for African American students in Birmingham. Historically, Parker has been recognized as being the heart of Black secondary education in Birmingham. Unfortunately, limited scholarly research exists detailing this historic schooling environment that motivated Black students to excel, despite vast inequities and inequalities. This dissertation tells the story of A.H. Parker High School with a focus on the culturally …

The Requirement Of Transcriptional Lim Complex Co-Regulators For Pancreatic Endocrine Cell Development And Function, Eliana Davi Toren

All ETDs from UAB

The prevalence and tremendous impact of diabetes mellitus has made glucose regulation of the insulin-producing -cell and surrounding pancreatic islet of Langerhans a center of public and research interests alike. A comprehensive understanding of these hormone-producing cells begins with their developmental origins. What are the genetic cues and participants in the tightly orchestrated process of their formation? Investigating the earliest determinants of islet-cell fate not only allows us to deeply understand mature - and islet-cell function, but also produces a data-driven template for how these cells can be reproduced in future stem-cell based diabetes therapies. LIM transcriptional complexes are indispensable …

Evaluating The Association Among Demographic, Disease, And Symptom Profiles And Quality Of Life In Connective Tissue Disease-Related Interstitial Disease, Lanier O'Hare

All ETDs from UAB

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Connective tissue disease-related interstitial lung disease (CTD-ILD) results in an unrelenting symptom burden and may progress to death. The morbidity and mortality associated with CTD-ILD likely has a profound impact on individuals’ quality of life (QOL). Quality of life is a phenomenon that has yet to be sufficiently described in the literature on CTD-ILD. The factors associated with QOL in other chronic lung diseases have been described, but because of the different clinical and demographic characteristics of CTD-ILD, it is unknown if these same factors are associated with QOL in CTD-ILD. The purpose of this study was to examine …

The Role Of Alternative Payment Models In Pharmaceutical Services And Outcomes, Matthew G. Parker

All ETDs from UAB

A persistent challenge within the healthcare sector is balancing cost containment for health services and the quality of care associated with these services. This challenge has reinvigorated interest in alternative payment models (i.e., risk-sharing, shared savings, capitation), arrangements between payers and healthcare providers that structure reimbursement for services based on health outcomes. Although much research has assessed the association between these payment models and financial outcomes for medical services, there is a paucity of research that has likewise assessed pharmaceutical outcomes (i.e., electronic prescribing, evidence-based prescribing, medication adherence). The papers comprising this dissertation contribute to this limited body of research …

A Case Study Of Classroom Practices For Additional Strategies In First Grade, Lori Stclair Rhodes

All ETDs from UAB

This study addresses first graders’ conceptual knowledge exhibited in addition strategies in relation to instructional practices and teachers’ beliefs in a suburban Alabama school. To address the purpose of the study, the central question was “What is the nature of the relationship between curricular practices and beliefs and students’ advanced strategy use for addition in first grade?” The study employs a case study design to obtain a deeper and more comprehensive view of students’ conceptual understanding exhibited in advanced addition strategies in the context of the first-grade classroom. Student addition strategies were compared to instructional practices and teachers’ beliefs to …

Superhero Media And Risk-Taking: Is Superhero Play A Risk Factor For Unintentional Injury In Preschool-Aged Children?, Casie H. Morgan

All ETDs from UAB

The preschool years represent a time of rapid human development, hallmarked by exploring one’s environment through gross and fine motor movement, touching and tasting physical objects, and imaginative pretend play. This exploration is developmentally appropriate, but also presents risks. Unintentional injury is the leading cause of death for preschool-aged children, and common injuries reflect exploration and risk-taking exhibited during play. Pretend play may be particularly risky if children imitate risky models like superheroes. Superhero media is extremely popular among young children, leading many children to identify closely with superheroes. Frequent exposure and subsequent identification with superheroes is concerning because media …

Examining Family Health Through Family-Centered Care Within An Organizational Context, Bria Kathryn Morgan

All ETDs from UAB

Introduction: Family health is characterized as a multi-dimensional process that is shaped by a number of social determinants. Similar to individual health, various domains work in conjunction and intersect to produce family health. Family-centered care is one of the many ways that healthcare providers can support health, however, little is known about if and how it is beneficial for family health. Considering the relevance of an organizational context, this study seeks to understand the delivery of care within an organization and providers’ perceptions of family-centered care. Data/Methods: Using the case of the Ronald McDonald House, this study integrates qualitative content …

Synergy Between Stenotrophomonas Maltophilia And Pseudomonas Aeruginosa During Polymicrobial Airway Infections, Melissa Skye Mcdaniel

All ETDs from UAB

Stenotrophomonas maltophilia is a Gram-negative bacillus that can act as an opportunistic pathogen in patients with respiratory diseases, including cystic fibrosis (CF) and ventilator-associated pneumonia. Infection with S. maltophilia is associated with worse lung function, but it remains unclear if this organism contributes directly to lung function decline. Lung infections are often polymicrobial, and S. maltophilia can be isolated from the lung with the key pulmonary pathogen Pseudomonas aeruginosa. In the first half of this work, we investigated the pathogenicity of S. maltophilia alone and during polymicrobial infection with P. aeruginosa. We used respiratory infections in mice to assess persistence …

Nutrition Practices And Body Composition In Infants Born Preterm, Maggie Jerome

All ETDs from UAB

Adequate nutrition and optimal growth are critical goals of clinical care for premature infants in the NICU due to rapid brain growth and development that occur during this time. Emerging evidence suggests that body composition in preterm infants is predictive of neurodevelopmental and metabolic outcomes later in childhood. The objective of this dissertation is to investigate factors affecting premature infant growth and body composition, including high enteral protein supplementation, nutrition during the first two weeks of life, and race of infants born at 22-32 weeks gestational age admitted to the UAB NICU. In a pilot study, 56 preterm infants were …

Evaluation Of A Living Shoreline Technique On A Southeastern United States Reservoir, Eric V. Muth

All ETDs from UAB

The impoundment of rivers in the southeastern United States has led to the creation of reservoirs that have seen the riparian zone become heavily developed with residential real estate. As the hybrid river/lake systems started forming new shorelines, property owners reacted by attempting to reduce their losses. This has been done in a variety of ways, with the majority falling into the bulkhead category. The use of vertical hard armament has resulted in a loss of ecological function and an increase in erosion of the lakebed at the toe or escarpment. In response to this, the idea was proposed by …

Molecular Imaging Of Cancer For Detection And Monitoring Of Response To Combination Therapy, Tiara S. Napier

All ETDs from UAB

Imaging is a primary component of cancer care and aids in diagnosing, response assessment, and monitoring. Molecular imaging techniques provide visualization of unique tumor biology that can be used to personalize treatment. Key features of an effective biomarker are sensitivity, specificity, and ability to provide clinical value beyond that of other types of information already available at the time of diagnosis. For particularly heterogeneous cancer subtypes, such as glioblastoma (GBM) and triple negative breast cancer (TNBC), reliable biomarkers can be challenging to identify and there are few tar-getable receptors for therapy. Our findings demonstrate that quantifying tumor EGFR (panitumumab-IRDye800CW), granzyme …

Restoring The Sphingolipid Balance In Glioblastoma, Cyntanna C. Hawkins

All ETDs from UAB

Glioblastoma (GBM) is a highly aggressive brain tumor with a median survival of 15 months even with standard of care—surgical resection, radiotherapy, and chemotherapy. Two of the key characteristics contributing to this malignancy are its highly invasive phenotype and resistance to the chemotherapy, temozolomide (TMZ). We, and others, have identified the sphingolipid balance as a driver of these phenotypes with dysregulated sphingolipid metabolism seen in GBM patient samples. The ceramidases, specifically acid ceramidase (ASAH1), mediate the balance between ceramides and sphingosine-1-phosphate (S1P). ASAH1 breaks down ceramides ultimately forming S1P. While ceramides induce cell death, S1P promotes migration and cell survival. …