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Water Absorption, Surface Roughness And Flexural Strength Assessment Of Peek With And Without Aging., Pranjal Ramchandra Daundakr Sep 2025

Water Absorption, Surface Roughness And Flexural Strength Assessment Of Peek With And Without Aging., Pranjal Ramchandra Daundakr

All ETDs from UAB

Polymethyl methacrylate (PMMA) has been the primary material for complete denture bases since its introduction in 1936 due to its esthetics, affordability, and ease of processing. However, PMMA demonstrates well-documented shortcomings, including relatively low flexural strength, high water absorption, and susceptibility to surface wear. These limitations lead to fractures, loss of occlusal vertical dimension (OVD), frequent relines, and compromised esthetics. Even advanced formats such as CAD-CAM milled and 3D printed PMMA remain prone to dimensional instability, microbial colonization, and long-term degradation. Polyetheretherketone (PEEK), a high-performance thermoplastic originally used in orthopedic and spinal implants, has recently been introduced into dentistry as …

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Policy Surveillance Of Decommissioning And Decontamination Regulations, Joshua Gary Collins Sep 2025

Policy Surveillance Of Decommissioning And Decontamination Regulations, Joshua Gary Collins

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Policy surveillance is an analytical collection and study of regulatory action within the public health field. Due to the vastness of the United States regulatory system, large amounts of time and effort are needed for policy surveillance to be accomplished. When considering nuclear decommissioning policies, all state and local regulations should start with the Nuclear Regulatory Commission’s (NRC) requirements, however states have the freedom to increase stringency. Policy surveillance allows for both a convenient and approachable way to reference important regulations in a timely manner while also functioning as a method to identify and manage any inconsistencies found between the …

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A Concurrent Mixed Methods Formative Process Evaluation Of A Telehealth Mental Health Awareness Program For People With Mobility Limitations, Sangeetha Mohanraj Sep 2025

A Concurrent Mixed Methods Formative Process Evaluation Of A Telehealth Mental Health Awareness Program For People With Mobility Limitations, Sangeetha Mohanraj

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People with mobility limitations face higher levels of mental health challenges and often face barriers to accessing mental health resources to overcome them. Raising mental health awareness and providing accessible resources are essential for improving the quality of life in this population. The NCHPAD’s (National Center on Health, Physical Activity, and Disability) GROWTH (Growing Resilience Out of Wellness and Thoughtful Habits) program is a telehealth mental health wellness program developed for individuals with mobility limitations. The primary objective of this dissertation is to conduct an process evaluation of the GROWTH pilot program using a mixed methods approach to assess its …

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In-Vitro Antimicrobial Activity, Demineralization Inhibition Potential, And Staining Effects Of Three Silver Fluoride Materials, Quiesly Torres Sep 2025

In-Vitro Antimicrobial Activity, Demineralization Inhibition Potential, And Staining Effects Of Three Silver Fluoride Materials, Quiesly Torres

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Background: Dental caries is a worldwide preventable public health problem. It affects any individuals regardless of their gender, age, ethnicity, and socioeconomic status. Silver diamine fluoride (SDF) has been extensively used for preventing cavities, but it has side effects; therefore, some other biocompatible antimicrobial and remineralization-inducing alternative materials have been developed. Purpose: This study aims to assess the in vitro antimicrobial activity, demineralization inhibition potential, and staining effect of SDF, Nano Silver Fluoride (NSF), and silver fluoride + potassium iodide (SF/KI). Methods: Three silver diamine fluoride-based materials were tested: SDF 38% (Advantage Arrest®, Elevate Oral Care, USA), 1500 ppm NSF …

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Air Pollution And Environmental Injustice Are Related To Respiratory Complications In Individuals With Sickle Cell Disease, Kelsey M. Maclin Sep 2025

Air Pollution And Environmental Injustice Are Related To Respiratory Complications In Individuals With Sickle Cell Disease, Kelsey M. Maclin

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Sickle cell disease (SCD) is a genetically inherited blood disorder affecting people of African descent. SCD is characterized by painful episodes and an acute lung injury known as acute chest syndrome (ACS). Patients with SCD have a life expectancy <19 years compared to Blacks without SCD. There is minimal research investigating air pollution and health complications in SCD. The aims of this research were to investigate whether pulmonary function is affected by exposure to ambient air pollution, whether higher air pollution concentrations are associated with hospitalizations for ACS, and whether environmental injustice impacts the respiratory health of children and young adults with SCD. Air pollution data on the criteria air pollutants (CAPs) was obtained from the US Environmental Protection Agency (EPA). Patient health data were obtained from Children’s Hospital of Alabama electronic medical records. Logistic regression, distributed lag non-linear regression, Granger Causality, and Getis-Ord Gi* hot spot analysis were used to analyze our data. The EPA’s EJScreen tool was used as a measure of exposure to environmental injustice. ArcGIS was used to map the EJScreen data. Exposure to short-term air pollution is significantly associated with a reduction in pulmonary function in children and young adults with SCD. Children and young adults exposed to a one-unit increase in the monthly average concentrations of sulfur dioxide (SO2) experienced an increase in the odds of having abnormal pulmonary function. We observed the trends of each criteria air pollutant in our study to be closely aligned with the trends in the hospitalizations for ACS. Most of our study participants with a history of ACS lived in areas burdened by greater environmental injustices. Specifically, the hot spots for ACS overlapped with the hot spots for PM2.5. Unequal exposure to environmental injustices leads to increases in hospitalizations for respiratory complications in individuals with SCD. Reductions in air pollution could be greatly beneficial to the pulmonary function and overall respiratory health of individuals with SCD. Further research is needed to examine associations between air pollution and hospitalizations for ACS in individuals with SCD.

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Core Body Temperature (Cbt) Monitoring Among Groundskeepers Under Heat Stress, Lara Anne Parker Sep 2025

Core Body Temperature (Cbt) Monitoring Among Groundskeepers Under Heat Stress, Lara Anne Parker

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Heat is the leading cause of death for outdoor workers. In Alabama, there are an estimated 11,160 - 21,460 workers employed in the landscaping and groundskeeping industry, which are vulnerable to heat-related illnesses (HRI). In this study, core body temperature (CBT) and wet-bulb globe temperature (WBGT) index were examined as potential indicators of heat stress. A SlateSafety (SS) Band V2 wearable CBT device and a WBGT monitor were used to collect CBT and WBGT values, respectively. Sampling for the main two measurements was performed over five days for two participants. An additional CBT device option, the e-Celsius performance ingestible pill, …

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Racial/Ethnic Heterogeneity In Women’S Aging Experiences Over Time: A Latent Transition Analysis, Joshua Christian Julian Lewis Sep 2025

Racial/Ethnic Heterogeneity In Women’S Aging Experiences Over Time: A Latent Transition Analysis, Joshua Christian Julian Lewis

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U.S. population aging and unprecedented racial/ethnic diversity will affect the types of social and healthcare services older adults need. These projections have renewed attention to healthy aging, which refers to the physiological/functional, psychological, and social capacity to maintain well-being. Extant research finds that most are aging unwell and through binary and biomedical operationalizations—which do not account for patterns of chronic conditions, disability, intersecting race / ethnic and gender inequality, socioculturally developed resources, and social relations—reifies the exceptions, typically men and non-Hispanic Whites, as the “aging well” benchmark. Integrating theoretical considerations of the life course, cumulative inequality, stress process, and limitations …

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Understanding The Functional Consequence Of Cul3 Deletion In The Mammalian Brain, Prathibha Sekar Sep 2025

Understanding The Functional Consequence Of Cul3 Deletion In The Mammalian Brain, Prathibha Sekar

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Polyubiquitination is a post-translational modification which often results in degradation of the ubiquitin-tagged protein. E3 ubiquitin ligases are multi-subunit protein complexes that assist in this ubiquitination process. Multiple genes that play a role in ubiquitination are implicated in autism spectrum disorder, a highly heterogeneous neurodevelopmental disorder. CULLIN3 (CUL3), a scaffolding protein part of the E3 ubiquitin ligase complex, is the product of a high-risk autism gene implicated across multiple large scale sequencing studies of autism patients. Additionally, CUL3 haploinsufficiency is associated with a syndromic disorder called NEDAUS (Neurodevelopmental disorder with or without autism or seizures) characterized by intellectual disability (ID), …

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Voices From Two Secondary Newcomer Programs In Alabama: A Multiple Case Study, Carl Anthony Floyd Jr Sep 2025

Voices From Two Secondary Newcomer Programs In Alabama: A Multiple Case Study, Carl Anthony Floyd Jr

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This multiple case study investigates the design, implementation, and impact of two secondary newcomer programs in Alabama, with a focus on Students with Limited or Interrupted Formal Education (SLIFE) and non-SLIFE English Learner (EL) newcomers. Grounded in Esteban-Guitart et al.’s (2023) framework of community funds of knowledge and identity, the study explores how these programs function as community educational ecosystems. Data were collected through interviews, observations, and document reviews across two school districts and analyzed using ethnographic and thematic methods. Findings reveal that when newcomer programs are intentionally designed to leverage community assets and cultural identities, they provide meaningful academic, …

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Parenting And Parental Well-Being As Risk And Resilience Factors For Mental Well-Being In Adolescents With And Without Neurodevelopmental Disorders, Wanqin Yu Sep 2025

Parenting And Parental Well-Being As Risk And Resilience Factors For Mental Well-Being In Adolescents With And Without Neurodevelopmental Disorders, Wanqin Yu

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Parenting practices and caregiver well-being are widely recognized as key determinants of adolescent mental health. However, few studies have examined how these factors operate in the context of neurodevelopmental disorders (NDDs), particularly through a risk and resilience framework. This study investigated how positive and negative parenting practices, caregiver well-being, and parenting stress relate to adolescents’ emotional well-being and internalizing problems. It also explored whether these variables differed between adolescents with and without NDDs. Participants included 105 adolescents aged 11–14 years (61.9% female; 52.4% diagnosed with an NDD) and their caregivers, drawn from a larger study on adolescent socio-emotional competencies. Caregivers …

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Origin And Differentiation Of Uterine Natural Killer Cells, Morgan Elizabeth-Carolyn Greene Sep 2025

Origin And Differentiation Of Uterine Natural Killer Cells, Morgan Elizabeth-Carolyn Greene

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Uterine natural killer (uNK) cells are specialized tissue-resident lymphocytes that are essential for successful pregnancy, yet the molecular pathways governing their development remain poorly defined. This knowledge gap hinders our ability to understand and treat immunological complications of pregnancy, such as recurrent pregnancy loss and pre-eclampsia. This dissertation addresses the fundamental question of how human uNK cells arise and differentiate, first within the non-pregnant endometrium and subsequently within the decidua of early pregnancy. Using single-cell RNA sequencing of matched human blood and endometrial samples, we first delineate the developmental trajectory of endometrial NK (eNK) cells. We demonstrate that eNK cells …

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The Impact Of Nursing Home Ownership On The Election Of Advance Care Directives, Natasha Elie Sep 2025

The Impact Of Nursing Home Ownership On The Election Of Advance Care Directives, Natasha Elie

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Approximately 1.3 million people reside in nursing homes/facilities. Annually, this population represents 25% of mortalities in the United States. The enactment of the Patient Self Determination Act (PSDA) required nursing homes/facilities to educate patients, staff, and the community on the right to advance care directives. This study aimed to evaluate the impact of nursing home ownership on the election of ACDs and end-of-life care services by examining how nursing homes ownership in New York, California, and Ohio compared regarding residents' election of ACD and whether there was a variation in the these states. This paper contributes to the literature by …

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Evaluating Relative Value Units And Its Alternatives Inradiology, Alfred Matthew Dewey Sep 2025

Evaluating Relative Value Units And Its Alternatives Inradiology, Alfred Matthew Dewey

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ABSTRACT Radiologist productivity in the United States is traditionally measured by thework Relative Value Unit (wRVU). However, wRVUs fail to capture several criticalaspects of radiologic work, including study complexity, patient characteristics, andfacility factors. This study evaluated the statistical significance of wRVUs as a measureof productivity and proposes an alternative model grounded in ascribable time—themeasurable duration a radiologist takes to interpret and report a study.A comprehensive literature review highlighted the inadequacy of wRVUs inaccounting for technological advances, case complexity, and workflow differences.Applying contingency theory as the guiding framework, this study posited that radiologyproductivity must be tailored to institutional and contextual variability. …

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An Analysis Of Gamma-Aminobutyric Acid Levels With Structural And Functional Connectivity In Antipsychotic Medication-Naïve First Episode Psychosis Patients, Genelle Dano Samson Sep 2025

An Analysis Of Gamma-Aminobutyric Acid Levels With Structural And Functional Connectivity In Antipsychotic Medication-Naïve First Episode Psychosis Patients, Genelle Dano Samson

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Schizophrenia is a complex psychiatric disorder characterized by hallucinations, delusions, disorganized thinking, and abnormalities in emotional expression, social interaction, and motivation. Cognitive deficits and alterations in perception are core features of psychosis spectrum disorders, though the neurobiological bases of these impairments are not thoroughly understood. Examination of the structures responsible for cognition, along with how their connectivity and neurochemistry are altered in psychosis, is crucial to understanding and treating schizophrenia. Gamma-aminobutyric acid (GABA) is the primary inhibitory neurotransmitter in the central nervous system and plays a crucial role in the regulation of neuronal activity. Evidence from animal models and postmortem …

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The Longitudinal Associations Between The Longitudinal Associations Between Parent Involvement And Academic Achievement In Elementary School Involvement And Academic Achievement In Elementary School, Makayla Elizabeth Warnecke Sep 2025

The Longitudinal Associations Between The Longitudinal Associations Between Parent Involvement And Academic Achievement In Elementary School Involvement And Academic Achievement In Elementary School, Makayla Elizabeth Warnecke

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Parent involvement has been positively linked to children’s academic outcomes (e.g., Chavkin, 1993; Eccles & Harold, 1993; Epstein, 1989, 1994; Hess & Holloway, 1984; Hobbs et al, 1984; U.S Department of Education, 1994). These outcomes include higher achievement test scores (Keith et al., 1986), better grades (NCES, 1985), and increased rates of secondary school completion (Chavkin & Williams, 1993; Delgado-Gaitan, 1988, 1992; Epstein, 1986, 1995; Angiano, 2004). However, gaps remain in the current state of research when investigating longterm implications. In a recent meta-analysis, researchers stated the lack of analyses using a longitudinal cross-lagged design as a future direction (Barger …

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Adult Role Transitions And Substance Use In Black And White Young Adults, Kristina Brooke Mcmahan Sep 2025

Adult Role Transitions And Substance Use In Black And White Young Adults, Kristina Brooke Mcmahan

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ADULT ROLE TRANSITIONS AND SUBSTANCE USE IN BLACK AND WHITE YOUNG ADULTS ABSTRACT Substance use, including alcohol, tobacco, and cannabis, often begins during adolescence and young adulthood, which is a developmental period marked by major life transitions such as graduating college, entering full-time employment, and parenthood. Adult role transition patterns may influence substance use and mental health outcomes; however, limited research has examined these associations in racially and socioeconomically diverse populations. The present study explored patterns of adult role transitions and their associations with substance use and mental health symptoms among young adults using data from Wave 4 of the …

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Randomized Control Trial Of A Novel Dental Gel As An Adjunct To Scaling And Root Planing In Subjects With Stage Ii & Iii Periodontitis, Efstratios Choreftakis Sep 2025

Randomized Control Trial Of A Novel Dental Gel As An Adjunct To Scaling And Root Planing In Subjects With Stage Ii & Iii Periodontitis, Efstratios Choreftakis

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Scaling and root planing (ScRP) is the gold standard for non-surgical periodontal therapy, yet no dentifrice has been definitively shown to improve its outcomes. This randomized controlled trial evaluated the effectiveness of LivFresh Dental Gel as an adjunct to ScRP in patients with Stage II and III periodontitis. Twenty-one participants were assigned to either a test group using LivFresh Dental Gel or a control group using a standard sodium fluoride dentifrice. Clinical parameters—including probing depth (PD), clinical attachment level (CAL), gingival index (GI), plaque index (PI), and bleeding on probing (BOP)—were assessed at baseline, 30, 90, and 180 days. The …

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Racial Discrimination And Inflammation In Adolescence: Ethnic/Racial Processes As Moderators, Queenisha Crichlow Sep 2025

Racial Discrimination And Inflammation In Adolescence: Ethnic/Racial Processes As Moderators, Queenisha Crichlow

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Discrimination and other psychosocial stressors contribute to chronic disease by dysregulating neuroendocrine and immune systems, which often leads to increased levels of inflammation. Given that inflammation is a key biological pathway associated with the development of chronic diseases, it has been proposed as a potential mechanism linking racial discrimination to poorer health. Most studies linking racial discrimination with inflammation have focused on adults, despite the fact that children and adolescents also experience discrimination. This dissertation explores the association between racial discrimination and inflammation, measured via salivary C-reactive protein (CRP) and proinflammatory cytokines, among Black and Hispanic adolescents. It also examines …

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Identifying The Neurobiological Substrates Of Gulf War Illness, Chloe Lisette Jones Sep 2025

Identifying The Neurobiological Substrates Of Gulf War Illness, Chloe Lisette Jones

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Gulf War Illness (GWI) affects approximately 30% of veterans who served in the 1991 Persian Gulf War and is characterized by chronic pain and fatigue, as well as cognitive, mood, gastrointestinal, and respiratory symptoms. Animal research has suggested that GWI is caused by a combination of neurotoxicants such as nerve gas, anti-nerve agent pills, and pesticides, though a definitive pathophysiological model has not been established. In this human observational study, 20 veterans with GWI and 20 healthy Gulf War veterans (HV) underwent whole-brain magnetic resonance spectroscopy (MRS) to non-invasively measure several metabolites associated with neuroinflammation. Whole blood was also collected …

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A High-Salt Diet Modulates Renal Afferent Nerve Activity; Potential Role Of The Endothelin System, Jiaxi Shen Sep 2025

A High-Salt Diet Modulates Renal Afferent Nerve Activity; Potential Role Of The Endothelin System, Jiaxi Shen

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Hypertension is a prevalent disease around the world. Increased blood pressure leads to a higher risk of stroke and coronary heart disease. Diet, lifestyle, and gene regulation are potential causative factors, and salt-sensitive hypertension is one common types of hypertension. In response to a high-salt diet, blood pressure may elevate with increasing risks of cardiovascular disease (CVD). Endothelin-1, which binds to endothelin A (ETA) and B (ETB) receptors, is strongly involved in controlling the blood vessels and sensory nerve signaling pathway between the kidney and the central nervous system during high salt dietary challenge. The function of the ETB receptor …

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Myelin Mapping In Psychosis, Victoria Lynn King Sep 2025

Myelin Mapping In Psychosis, Victoria Lynn King

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It is well established that myelin in the central nervous system is an axonal insulator which speeds the conduction velocity of action potentials. However, its role in the cortex has also been shown to support metabolic demands and aid in cortical plasticity. Myelin develops throughout childhood and adolescence from sensorimotor areas to association areas and peaks during adolescence. Importantly, this is the same time that psychosis-spectrum disorders (PSDs) begin to present clinically; thus, given the critical role of myelination in shaping the mature cortex, disruptions in this process – particularly during adolescence – are thought to partially explain the onset …

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Moving Beyond M1/M2: Xenoline-Polarized Macrophages As A Physiologically Relevant Model Of Tumor-Associated Macrophages In Glioblastoma, Hasan Alrefai Sep 2025

Moving Beyond M1/M2: Xenoline-Polarized Macrophages As A Physiologically Relevant Model Of Tumor-Associated Macrophages In Glioblastoma, Hasan Alrefai

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Glioblastoma (GBM) remains one of the most treatment-refractory cancers, with few therapeutic advances translating into survival benefit. With a median survival of just 15-18 months, the need for effective therapies is urgent. A key obstacle is the underutilization of tumor-associated macrophages (TAMs) in preclinical models. TAMs account for a sizable proportion of GBM by mass and drive malignant behaviors such as angiogenesis, invasion, and resistance to chemoradiotherapy, making them attractive therapeutic targets. Unfortunately, most in vitro GBM-TAM models are inadequate, as they fail to capture the cellular heterogeneity and microenvironmental interactions that drive tumor progression, therapeutic resistance, and immune evasion. …

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Probiotic Biogeography In The Neonatal Intestine, Sierra Hansen Sep 2025

Probiotic Biogeography In The Neonatal Intestine, Sierra Hansen

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Neonatal infection remains a leading cause of both neonatal morbidity and mortality worldwide, particularly in preterm infants. Probiotic bacteria have been demonstrated to protect against the development of neonatal intestinal dysbiosis, however, formulations and efficacy vary substantially, highlighting a critical gap in the current understanding of the mechanisms governing probiotic efficacy in this population. This gap is exacerbated by regulatory standards which favor economic expansion over scientific rigor. Furthermore, current studies on probiotic efficacy largely rely on indirect or relative readouts of intestinal bacterial burden. Herein, we directly quantify the probiotic effects of Ligilactobacillus murinus V10 and Escherichia coli Nissle …

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Structural Basis For Promoter Recognition By Pseudomonas Phage Dev Virion Associated Rna Polymerase, Brittney Bird Sep 2025

Structural Basis For Promoter Recognition By Pseudomonas Phage Dev Virion Associated Rna Polymerase, Brittney Bird

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Bacteriophage DEV, a member of the Schitoviridae family, encodes a large virion-associated RNA polymerase (vRNAP) and shows significant potential for use in phage therapy. However, many aspects of DEV’s biology remain poorly understood, especially how it regulates transcription once inside the host. Recent work in our lab suggests that gene product 71 (gp71) functions as a DNA-dependent vRNAP. Analogous to the vRNAP of coliphage N4, gp71 likely initiates transcription by recognizing single-stranded DNA templates that contain early gene hairpin promoters. Based on this, my working hypothesis is that specific interactions between gp71 and the DEV early promoters PE1 and PE5 …

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Impact Of Alpha-Synuclein Aggregation On Corticostriatal Synaptic Function And Morphology, Charlotte Franziska Brzozowski Sep 2025

Impact Of Alpha-Synuclein Aggregation On Corticostriatal Synaptic Function And Morphology, Charlotte Franziska Brzozowski

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Lewy Body Dementias (LBDs), including Parkinson’s Disease Dementia (PDD) and Dementia with Lewy Bodies (DLB), are defined by α-synuclein (α-syn) accumulation in Lewy Pathology (LP). LP is abundant in cortical layer V intratelencephalic (IT) neurons, a subset of neurons that also degenerate in the pre-supplementary motor area (preSMA) in humans, which is homologous to the secondary motor cortex (M2) in mice, as observed in PD postmortem tissue. IT neuron projections to the striatum are an intrinsic part of the motor basal ganglia circuitry, believed to modulate cognitive aspects of executive motor control, such as updating motor plans. M2 projections to …

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Characterizing The Role Of Pneumococcal Surface Protein A And Humoral Immunity To Biofilm Antigens During Streptococcus Pneumoniae Colonization, Jessica Lane Sep 2025

Characterizing The Role Of Pneumococcal Surface Protein A And Humoral Immunity To Biofilm Antigens During Streptococcus Pneumoniae Colonization, Jessica Lane

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Streptococcus pneumoniae (Spn), or “the pneumococcus”, is a Gram-positive bacterium that colonizes the upper respiratory tract as a pathobiont. Spn is a deadly human pathogen, and one of the leading etiological agents of community-acquired pneumonia (CAP). One virulence factor of Spn is pneumococcal surface protein A (PspA), a choline-binding protein (CBP) at the surface of the bacteria that interacts with the host environment. Here, we demonstrated a novel role for PspA involving adhesion to dying host nasal epithelial cells via a multimeric complex with host lactoferrin (LF) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH). We found that the PspA-GAPDH complex aggregated the bacteria …

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"Organizational Characteristics And Market Factors Associated With The Adoption Of Hospital At Home", Vincent Turner Sep 2025

"Organizational Characteristics And Market Factors Associated With The Adoption Of Hospital At Home", Vincent Turner

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ORGANIZATIONAL CHARACTERISTICS AND MARKET FACTORS ASSOCIATED WITH THE ADOPTION OF HOSPITAL AT HOME VINCENT TURNER, JR. HEALHTCARE LEADERSHIP ABSTRACT The healthcare environment has continued to be reshaped and forced to evolve over the last several decades and even more so in recent years. This evolution and reshaping have been forced by both internal and external factors withing the healthcare landscape. This has tasked hospital leaders with exploring new ways of delivering care. The COVID-19 pandemic was an external circumstance the forced hospital leaders to look at alternate ways of providing care, more specifically in the home setting. Hospitals were introduced …

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Understanding Clinical Tool Adoption In Primary Care: A Case Study Of The Cmds Care Pathway, Khushbu Khatri Park Sep 2025

Understanding Clinical Tool Adoption In Primary Care: A Case Study Of The Cmds Care Pathway, Khushbu Khatri Park

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The rising prevalence of obesity, diabetes, and cardiovascular disease (CVD) places increasing strain on healthcare systems and primary care providers (PCPs). In response, the University of Alabama at Birmingham (UAB) adapted the Cardiometabolic Disease Staging System (CMDS), a validated clinical decision support tool, designed to stratify patient risk and guide evidence-based treatment. Embedded within the electronic health record (EHR) as a Care Pathway, the CMDS was designed for real-time use during primary care visits. This dissertation examines utilization of the CMDS in a two-phase case study, guided by the Adult Learning Theory, Group Dynamics Theory, Force Field Theory and Change …

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Bridging The Gap: Exploring The Facilitators And Barriers In The Self-Management Of Diabetes And Pain In Rural Southern Communities, Kennedy Nicole Butler Sep 2025

Bridging The Gap: Exploring The Facilitators And Barriers In The Self-Management Of Diabetes And Pain In Rural Southern Communities, Kennedy Nicole Butler

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Southern rural communities experience a higher prevalence of Type 2 diabetes (T2D) and associated comorbidities, which increases rates of premature mortality due to socio-environmental factors, pre-existing health conditions, and economic burden in comparison to their urban counterparts. Fifty percent of individuals with T2D experience pain or chronic pain (CP); however, individuals in rural communities disproportionately experience symptoms of CP. CP is a physically debilitating condition that can inhibit mobility and reduce quality of life. T2D and the co-occurrence of CP can limit an individual's ability to engage in self-managing behaviors. While diabetes self-management education and support (DSMES) programs, along with …

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The Association Of Resilience Factors With Mental Health Outcomes Among Middle-Aged And Older People Living With Hiv, Jeremy Delgadillo Sep 2025

The Association Of Resilience Factors With Mental Health Outcomes Among Middle-Aged And Older People Living With Hiv, Jeremy Delgadillo

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Research suggests that people living with HIV (PLWH), an aging chronic health population, have higher prevalence rates and severity of mental health and substance use disorders compared to people living without HIV (PLWoH). Cross-sectional and longitu-dinal studies have suggested intrapersonal resilience factors may serve a protective function in reducing the prevalence and severity of mental health and substance use outcomes among PLWH. The purpose of the current study was two-fold. The first aim was to systematically review the current state of the literature from 2000 to present that examined the associations between intrapersonal resilience factors and mental health outcomes among …

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