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The Relationship Of Bedside Assessment Of Orientation And Cognition To Treatment Outcome In Moderate To Severe Traumatic Brain Injury: A Growth Curve Analysis, Amber Marie Fahey Jan 2019

The Relationship Of Bedside Assessment Of Orientation And Cognition To Treatment Outcome In Moderate To Severe Traumatic Brain Injury: A Growth Curve Analysis, Amber Marie Fahey

All ETDs from UAB

Disorientation and cognitive impairment are commonly experienced in acute moderate to severe TBI patients and deficits early in recovery are predictive of worse long-term outcome. Hence, tracking recovery over time is a significant aspect of rehabilitation research. The Orientation-Log (O-log) and Cognition-Log (Cog-log) are important clinical measures used to monitor cognitive progress during treatment and previous research has shown them to be predictive of long-term outcome. This study used two-level growth curve modeling to, 1) determine the growth trajectory of orientation and cognition in persons with moderate to severe TBI in acute rehabilitation, as determined by the O-log and Cog-log, …


Bet Bromodomain Inhibition As An Approach For Treatment Of Cholangiocarcinoma, Samuel Charles Fehling Jan 2019

Bet Bromodomain Inhibition As An Approach For Treatment Of Cholangiocarcinoma, Samuel Charles Fehling

All ETDs from UAB

Cholangiocarcinoma (CCA) is a highly aggressive neoplasm which arises from the epithelial layer of the biliary tract. It is the second most common primary hepatic malignancy. As CCA is typically diagnosed at late disease stage, the current standard of care, resection followed by gemcitabine with cisplatin, is not effective. Further, up to 90% of CCA patients are ineligible for resection. Of those eligible for resection, postoperative chemotherapy does not prolong overall survival leading to a 5-year survival of ~30%. Previously, mutations have been identified in KRAS (17% of CCA cases), TP53 (44%) and SMAD4 (17%) but none have been recognized …


Transdisciplinary Problem-Solving Using Convergence-Based Engineering Modeling And Communication Theory, Darrell Fielder Jan 2019

Transdisciplinary Problem-Solving Using Convergence-Based Engineering Modeling And Communication Theory, Darrell Fielder

All ETDs from UAB

Convergence, an approach to problem-solving that transcends disciplinary boundaries, is increasingly viewed as a key enabler in the development of timely, cost-effective, and resilient solutions for some of society’s most vexing problems in healthcare, energy, and other complex problem domains. This transdisciplinary convergence, with its emphasis on collaboration beyond traditional disciplinary boundaries (electrical engineering, mechanical engineering, biomedical engineering, computer engineering, and project management), is necessary to bridge the communication chasms that often emerge in silo-based research and problem-solving. These communication rifts, deepened by language, jargon, process, and technical differences between disciplines, represent major impediments to collective research. In this dissertation, …


Utilization Of The Zebrafish Model System To Predict Effects Of Dietary Lipid Composition On Human Health, Lauren Adele Fowler Jan 2019

Utilization Of The Zebrafish Model System To Predict Effects Of Dietary Lipid Composition On Human Health, Lauren Adele Fowler

All ETDs from UAB

Obesity is a disease that encompasses the interaction of both genetics and life-style factors, and the pathology behind its development remains unclear. Specifically, defining the influence of dietary lipid intake on adiposity and metabolic health continues to be a fundamental challenge, and the use of animal models will be required to gain a full understanding of the processes contributing to diet-induced obesity in humans. The zebrafish Danio rerio has emerged as a powerful model system to study diet-induced obesity and metabolic disease in humans, while simultaneously offering multiple advantages over rodent models. This dissertation addresses multiple aspects regarding the use …


Rituals Of Reconciliation: The Use Of Peaceful Interactions To Repair Relationships, Sheila Renee Gainer Jan 2019

Rituals Of Reconciliation: The Use Of Peaceful Interactions To Repair Relationships, Sheila Renee Gainer

All ETDs from UAB

Reconciliation is the process by which social animals maintain valuable social relationships. It has been documented in many species including humans and nonhuman primates. While evidence of rituals has been seen in other species, the primary aim of this research is to explore how ritual behaviors are interconnected to human acts of reconciliation. Rituals are habitual activities closely linked to important events and reaffirm the identity of those who practice them as a group or a society. They are found in every society, culture and religion. In this study, rituals specifically related to reconciliation were exhibited in 27 of 138 …


Workplace Bullying Attitudes And Opinions In Local Government Employees, Regan Gaskin Jan 2019

Workplace Bullying Attitudes And Opinions In Local Government Employees, Regan Gaskin

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Bullying is an issue that can affect children, adolescents, and adults (Gould, 2014; Schmidt, 2017). When bullying occurs in the workplace, it causes difficulty not only for victims, but for witnesses, families, and the organizations (Leymann, 1992). Workplace bullying has been defined as the “repeated mistreatment; abusive conduct that is: threatening, humiliating, or intimidating, work sabotage, or verbal abuse” (Namie, 2014). An estimated 60.3 million US workers are affected by workplace bullying, and 20 percent are victims (Namie, 2017). Workplace bullying research in the United States has focused more on the private sector, and to the author’s knowledge, there is …


Design Of A Truck-Mounted Attenuator With Tube Folding Technology, Santosh Gautam Jan 2019

Design Of A Truck-Mounted Attenuator With Tube Folding Technology, Santosh Gautam

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DESIGN OF A TRUCK-MOUNTED ATTENUATOR WITH TUBE FOLDING TECHNOLOGY SANTOSH GAUTAM MECHANICAL ENGINEERING ABSTRACT Highway safety features have been continuously developed and employed over the years to protect vehicle occupants, pedestrians and work zone personnel from injuries in roadside accidents. The new truck-mounted attenuator designed and evaluated in this study aims to dissipate impacting energy of the errant vehicle in a controlled manner using a tube folding mechanism. Finite element modeling using LS-DYNA is used to study the performance of the designed truck-mounted attenuator. It is required to safely bring passenger vehicles travelling at a speed of 62 mph to …


Competitive Strategies Of Hospitals: Antecedents And Association With Financial Performance, Akbar Ghiasi Jan 2019

Competitive Strategies Of Hospitals: Antecedents And Association With Financial Performance, Akbar Ghiasi

All ETDs from UAB

In this three-paper dissertation, first, we examined the relationship between strategic group membership and hospital financial performance in terms of operating margin. The results revealed the important role of strategy on financial performance of a hospital. In the second paper, organizational and environmental antecedents of hospital’s business strategy choice were studied. The results showed that environmental and organizational factors may predict the business strategy choice of hospitals. The third paper investigated the moderating effect of environmental instability on the relationship between strategic group membership and financial performance. Environmental instability does not strongly affect the relationship between hospital strategic group membership …


Baf Chromatin Landscaping During Bone Formation And Maintenance, Tanner Cole Godfrey Jan 2019

Baf Chromatin Landscaping During Bone Formation And Maintenance, Tanner Cole Godfrey

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Bone loss is a worldwide problem resulting in increased risk of fracture. Osteoblasts are responsible for bone synthesis; therefore, treatments promoting osteoblast differentiation and/or activity would result in increased bone formation. The regulation of DNA accessibility is a key mechanism controlling gene expression and cellular differentiation. BAF (BRG1 Associated Factor) mediated chromatin remodeling increases DNA accessibility by sliding or ejecting nucleosomes. This process can occur in a cell type specific manner based on the composition of BAF. In many tissue types, a unique combination of BAF subunits has been identified to be responsible for the maintenance or differentiation of that …


Nursing Staff Approaches To Providing Oral Hygiene In Stroke Survivors With Dysphagia: A Grounded Theory Study, Willard Edward Brewer Jan 2019

Nursing Staff Approaches To Providing Oral Hygiene In Stroke Survivors With Dysphagia: A Grounded Theory Study, Willard Edward Brewer

All ETDs from UAB

The purpose of this qualitative grounded theory study was to explore how the nursing staff approaches oral hygiene in stroke survivors with dysphagia during the rehabilitation phase of recovery and what guides their decisions. Oral hygiene is a proven effective task known to prevent systemic health disparities (i.e. aspiration pneumonia, diabetes, gastrointestinal disparities, and even stroke). However, there are no current evidenced-based guidelines that provide instruction on how to execute oral hygiene to stroke survivors with dysphagia. Little is known about how nurses make decisions to implement oral hygiene in stroke survivors with dysphagia. Using a theoretical sampling strategy, data …


Integration Of Cone Photoreceptor Signals In Macaque Lgn Neurons, Paul B. Brown Jan 2019

Integration Of Cone Photoreceptor Signals In Macaque Lgn Neurons, Paul B. Brown

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Despite advances in the understanding of the primate visual system, much is yet to be learned about the way light signals sum to create our perception of the world. This is especially true at the simplest level of visual processing—the summation of two individual cone photoreceptor signals. How such signals combine to create visual perception has not been assessed in vivo. We used an adaptive optics scanning laser ophthalmoscope (AOSLO) to deliver binarized noise movies to identified groups of cones within the receptive fields of neurons in the macaque lateral geniculate nucleus (LGN). Recordings of neural action potentials within the …


The Impact Of Redox Stress In Primary Hyperoxaluria Type 1, Brianna Buchalski Jan 2019

The Impact Of Redox Stress In Primary Hyperoxaluria Type 1, Brianna Buchalski

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Primary Hyperoxaluria (PH) is a family of three inborn errors of glyoxylate metabolism resulting in endogenous oxalate overproduction. PH1 is the most common and most severe form of the disorder when compared to PH2 and PH3. PH1 can result in systemic oxalosis or end stage renal disease, and there is currently no cure for this disorder. The only curative treatment is combined liver/kidney transplant. The difficulty in defining a cure for the disorder arises from poor knowledge of the sources of endogenous oxalate and a lack of understanding in the underlying pathophysiology of the disorder. For these reasons, we have …


Receptor Sialylation By St6gal-I Promotes Tumor Progression By Enhancing Tumor Cell Survival And Epithelial To Mesenchymal Transition, Colleen Maeve Britain Jan 2019

Receptor Sialylation By St6gal-I Promotes Tumor Progression By Enhancing Tumor Cell Survival And Epithelial To Mesenchymal Transition, Colleen Maeve Britain

All ETDs from UAB

The upregulation of a certain subset of glycosyltransferases was an early marker for cancer development. Specifically, ST6Gal-I, which adds an α2-6 linked sialic acid to N-glycans on proteins bound for the plasma membrane or secretion, is selectively upregulated upon malignant transformation. Our laboratory has shown that ST6Gal-I is implicated in many facets of tumor biology and is an important mediator of tumorigenesis. For example, ST6Gal-I activity promotes the survival of cells when challenged with hypoxia, FasL, or TNFα, confers resistance to chemotherapeutics, enhances tumor cell migration and invasion, and fosters a cancer stem cell phenotype. The work presented in this …


Context Fear Memory Formation Is Regulated By Hippocampal Lncrna-Mediated Histone Methylation Changes, Anderson Alan Butler Jan 2019

Context Fear Memory Formation Is Regulated By Hippocampal Lncrna-Mediated Histone Methylation Changes, Anderson Alan Butler

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The post-translational modification of histones regulates gene expression and is critical for the formation and maintenance of hippocampus-dependent long-term memories. Changes in gene-specific expression of various epigenetic marks during the aging pro-cess are sufficiently consistent as to be used as an aging landmark or epigenetic clock in both humans and other species; however, the molecular mechanisms which govern the application of these marks aging are poorly explored. Recently, long noncoding RNAs (lncRNAs) have been implicated as regulators of histone methyltransferases and other chromatin-modifying enzymes (CMEs). Despite the relevance of such mechanisms to both aging and memory formation, the behavioral relevance …


Significance Of Acculturation, Assimilation, And Allostatic Load As Risk Factors For Obesity Among Hispanics, Yenni Elvia Cedillo Juare Jan 2019

Significance Of Acculturation, Assimilation, And Allostatic Load As Risk Factors For Obesity Among Hispanics, Yenni Elvia Cedillo Juare

All ETDs from UAB

Obesity has increased during the last two decades in the United States (U.S.) and is considered a major risk factor for chronic diseases within the Hispanic community. The burden of obesity in Hispanics is associated with higher rates of morbidity and mortality and an increase in healthcare costs. Hispanics’ challenges after migration extend to subsequent generations, putting the population at risk for disease development. Specifically, migration can lead to the adoption of health behaviors, beliefs, values, and language of the host country, a process known as acculturation, which has been associated with changes in health behaviors. Among the Hispanic population, …


Personal, Environmental, And Behavioral Factors Of Condom Use Among African American Adolescent Males, Jessica Thames Chambliss Jan 2019

Personal, Environmental, And Behavioral Factors Of Condom Use Among African American Adolescent Males, Jessica Thames Chambliss

All ETDs from UAB

Risky sexual behaviors among adolescents increase the negative outcomes of the occurrence of an unplanned pregnancy and contracting or transmitting disease. Adoles- cents that engage in risky sexual activities are at greater risk for adverse health and social outcomes. Unfortunately, the impact of pregnancy and sexually transmitted infections (STIs) among adolescents is far-reaching and does not only affect the immediate individuals. Despite a decline in teen pregnancy and birth rates, the diagnosis of STIs is steadily increasing among adolescents. Moreover, African American adolescent males in the United States and specifically in Alabama are disproportionally more at risk for STIs. Additionally, …


Sexual Behaviors And Non-Initiation Of The Hpv Vaccine Among Young Adult Cancer Survivors, Brooke Cherven Jan 2019

Sexual Behaviors And Non-Initiation Of The Hpv Vaccine Among Young Adult Cancer Survivors, Brooke Cherven

All ETDs from UAB

Advances in treatment for childhood cancer have led to increased survival rates. There are currently an estimated 400,000 survivors of childhood cancer living in the United States who are at risk for developing subsequent malignancies, including cancers associated with the human papillomavirus (HPV). HPV is the most common sexually transmitted infection; sexual behaviors associated with increased risk for HPV acquisition include younger age at first intercourse, multiple sexual partners, and inconsistent condom use. The prevalence of high-risk sexual behaviors, and the relationship between sexual behaviors and HPV vaccine non-initiation among young adult cancer survivors is unknown. This study used data …


Examining Naloxone Access: A Spatial Asessment Of Opioid Use In Urban And Rural Contexts, Keith Chichester Jan 2019

Examining Naloxone Access: A Spatial Asessment Of Opioid Use In Urban And Rural Contexts, Keith Chichester

All ETDs from UAB

Background: Elements of the physical environment have been shown to influence health behaviors including drug use and overdose mortality. Throughout the opioid epidemic in the United States, rural regions have been disproportionately affected by opioid overdose. Although the relationship between the urban built environment and opioid overdose has been established, little is known as to how trends may differ in rural areas. Methods: Risk terrain modeling was used as a spatial analytical approach to assess environmental features that significantly increase the risk of opioid overdose in Jefferson County, Alabama. Spatial risk assessments were conducted for urban and rural regions as …


The Strategy Of Federally Qualified Health Centers: The Influence Of Context And Performance Implications, Seongwon Choi Jan 2019

The Strategy Of Federally Qualified Health Centers: The Influence Of Context And Performance Implications, Seongwon Choi

All ETDs from UAB

The three papers included in this dissertation attempt to provide empirical evidence on the relationship among strategies employed by Federally Qualified Health Centers (FQHCs), the contextual factors and consequent performance. The findings of these studies contribute to the existing body of literature on FQHC strategies and performance. In addition, the findings also provide key practical implications to FQHC managers as well as policymakers. Overall, the results of this dissertation suggest that the FQHC strategy on spatial differentiation is associated with a set of organizational and environmental factors. However, there was little support for the relationship between Medicaid expansion and FQHC …


A Survey Of Shoulder Injuries In Commercial Truck Drivers Using A Retrospective Medical Record Review, Bryan Combs Jan 2019

A Survey Of Shoulder Injuries In Commercial Truck Drivers Using A Retrospective Medical Record Review, Bryan Combs

All ETDs from UAB

Introduction: Musculoskeletal injuries in the occupational setting have significant impact on the worker, employer, and healthcare system. Commercial truck drivers (CTD) experience some of the highest rates of injury, missed days of work, and workers’ compensation costs compared with other workers. In this population, back injuries occur most commonly, followed by shoulder injuries which require 5 times more days away from work. Commercial truck drivers are significantly impacted by shoulder injuries; however, little is known about the unique mechanisms of injury, specific injuries, or possible preventative measures among this group of workers. Methods: A retrospective medical record review was completed …


The Civil Rights Struggle For Black Economic Opportunity In Birmingham, Logan Montgomery Barrett Jan 2019

The Civil Rights Struggle For Black Economic Opportunity In Birmingham, Logan Montgomery Barrett

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This thesis examines the intersection between Birmingham, Alabama’s civil rights movement and labor history. It considers the city leadership’s exploitation of black labor and the radical resistance these oppressive conditions fostered. A long civil rights struggle in Birmingham emphasizes the movement’s pursuit of economic opportunity in securing a better quality of life for the city’s African American population. Showcasing three distinct eras of Birmingham’s black freedom struggle, this thesis argues that economic justice remained at the core of the prolonged movement. During the first half of the twentieth century, the city’s black working class embraced radical influences in combating workplace …


Validity Of Actigraph Gt3x Accelerometer In Determining Energy Expenditure, Brandon Dean Beamon Jan 2019

Validity Of Actigraph Gt3x Accelerometer In Determining Energy Expenditure, Brandon Dean Beamon

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ABSTRACT The purpose of this investigation was to examine estimates of energy expenditure from the Actigraph GT3X tracking device compared to that obtained by indirect calorimetry. Twenty-seven healthy Caucasian males at the University of Alabama at Birmingham (age 20-30 y) with a BMI range of 19.5 and 30 kg/m2 were asked to wear an Actigraph GT3X on the wrist, hip, and ankle while performing exercise on a treadmill, bike, and upper body ergometer in randomized order. After twelve regressions divided into two sections 4 with ankle, hip, and wrist included in the model, and 4 with the ankle site omitted) …


Mechanisms Of Acute Kidney Injury: The Role Of Ferritin Heavy Chain In Renal Heme-Unology, Laurence Marie Black Jan 2019

Mechanisms Of Acute Kidney Injury: The Role Of Ferritin Heavy Chain In Renal Heme-Unology, Laurence Marie Black

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The kidneys are complex, multi-faceted organs that are responsible for regulatory processes, such as fluid homeostasis, hormone production, blood pressure regulation, and systemic toxin removal. Sudden disruption of these processes by acute kidney injury (AKI) causes rapid decline in renal function as well as significant morbidity and mortality. AKI is a significant clinical concern, affecting up to 13.3 million people globally each year and has the propensity to progress to chronic kidney disease (CKD), though the mechanism remains undefined. One reason for this is due to the lack of understanding of models used to study both AKI and CKD, hindering …


Physical Activity Promotion Among Adolescents With Pediatric Onset Multiple Sclerosis, Elizabeth Morghen Sikes Jan 2019

Physical Activity Promotion Among Adolescents With Pediatric Onset Multiple Sclerosis, Elizabeth Morghen Sikes

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Pediatric onset multiple sclerosis (MS) is a chronic and disabling disease of the central nervous system with an onset before 18 years of age. Youth with pediatric onset MS may benefit from physical activity as evidenced by past research suggestsing higher levels of physical activity are associated with reduced physical and psychosocial disease manifestations. Unfortunately, published estimates of physical activity participation among those with pediatric onset MS are very low (<10 min/day). This dissertation aimed to describe the current literature regarding physical activity among youth with pediatric MS, and to further explore experiences, patterns, correlates, and potential confounders of physical activity for the ultimate purpose of informing future behavior change interventions. Results are presented through five single study chapters. Briefly, interventions developed to promote physical activity for adolescents with pediatric onset MS should be individually tailored, include a strong social component, aim to educate regarding safety and outcomes of physical activity, and differentially target weekday and weekend day activity and sedentary behavior. Social cognitive theory (SCT) is an appropriate method for promoting physical activity behavior change among youth with pediatric onset MS, and SCT constructs including exercise goal setting, barriers self-efficacy, outcome expectations, and social support should be incorporated in the intervention as appropriate. Further, physical activity is seemingly an appropriate method for the management of functional limitations for youth with pediatric onset MS. Clinicians and researchers seeking to promote physical activity among those with pediatric onset MS may find this dissertation especially useful in providing a framework for the development of behavior change interventions.


Characterization Of Chemical Uptake And Aryl Hydrocarbon Receptor Mutations In Zebrafish, Jaclyn Paige Souder Jan 2019

Characterization Of Chemical Uptake And Aryl Hydrocarbon Receptor Mutations In Zebrafish, Jaclyn Paige Souder

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In a society driven by technology and industry, we must be increasingly aware of how changes to our environment impact our health. This is especially true concerning embryonic development, which is easily influenced by extra-embryonic factors, including environmental contaminants. Determining how exogenous compounds are absorbed, which receptors they act through, and how these receptors act endogenously is important to fully understand to what extent developmental exposures impact fetal and adult health. I have used the zebrafish model system to address these questions for two classes of environmentally-relevant chemicals—estrogens and dioxins. First, I developed an assay to measure the uptake of …


Drive-By Bridge Monitoring And Damage Detection, Chengjun Tan Jan 2019

Drive-By Bridge Monitoring And Damage Detection, Chengjun Tan

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Bridges are key components of the transportation network, and their safety is essential to maintain effective and safe operation of the transportation facilities. To maintain the structural integrity of the bridges, it is essential to estimate the extent and location of the structural damage through periodic monitoring. Therefore, there is considerable interest in bridge damage detection and considerable progress has been made in recent years. The traditional bridge health monitoring requires many sensors installed on the bridge to collect vibration data for damage assessment, which is expensive, time-consuming, and even dangerous in-site. Compared with traditional ways, the concept of indirect …


Acetylcholine Signaling In Glioblastoma Invasion And Peritumoral Hyperexcitability, Emily Grace Thompson Jan 2019

Acetylcholine Signaling In Glioblastoma Invasion And Peritumoral Hyperexcitability, Emily Grace Thompson

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Glioblastomas are the most common and deadly form of primary brain cancer in adults. Current treatment strategies are aggressive, including a combination of surgical resection, radiotherapy, and chemotherapy. However, median patient survival has remained stagnant at 12 to 15 months for the last several decades. This dismal patient outcome has prompted efforts to understand the unique characteristics of these tumors, since traditional therapeutics have not been efficacious. Extensive invasion is a salient feature of glioblastomas that significantly diminishes the effectiveness of current treatment strategies and is ultimately the cause of tumor recurrence within 2 years in approximately 80% of patients. …


Intraocular Pressure Dynamics, Daniel Coleman Turner Jan 2019

Intraocular Pressure Dynamics, Daniel Coleman Turner

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While cataracts (the leading cause of blindness worldwide) can be reversed surgical-ly, glaucoma is the leading cause of irreversible blindness, affecting over 70 million people worldwide [1]. Elevated intraocular pressure (IOP) and age are the primary risk factors for glaucoma [2] and lowering IOP is the only proven treatment for the disease [3]. IOP and its fluctuations affect nearly every aspect of ocular physiology and homeo-stasis, as well as playing a dominant role in glaucoma pathophysiology, yet very little is known about IOP due to the current clinical standard of measuring mean IOP during infre-quent clinic visits. We use a …


The Anti-Tumor Effects Of Hur Inhibition In Glioblastoma, Jiping Wang Jan 2019

The Anti-Tumor Effects Of Hur Inhibition In Glioblastoma, Jiping Wang

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Glioblastomas (GBMs) are the most malignant primary brain tumor. GBMs represent 14.7% of total primary CNS tumors and 47.7% of malignant CNS tumors. The median survival of GBM is 18-20 months, while five-year survival rate is only 5.6%. GBMs are maintained by glioma stem cells (GSCs), and poor treatment outcomes are linked to the high resistance of GSCs to radiation and chemotherapy, and the immunosuppressive tumor microenvironment. The mRNA binding protein HuR is a key regulator of tumor growth and development based upon the fact that HuR targets mRNAs that are broadly involved in tumorigenesis. We have previously shown that …


Obesity In People With Spinal Cord Injury: Secondary Data Analysis Of National Spinal Cord Injury Database, Huacong Wen Jan 2019

Obesity In People With Spinal Cord Injury: Secondary Data Analysis Of National Spinal Cord Injury Database, Huacong Wen

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People with disabilities are 1.5-2.5 times more likely to be obese than those without disabling conditions. We have learned a lot about obesity in the general population. However, the neurological deficits of people with spinal cord injury (SCI) make it difficult to generalize the findings in the general population to the SCI population. Therefore, the purposes of this dissertation were to 1) assess racial differences in body mass index (BMI) change over 5 years; 2) evaluate the role of neighborhood in the relationship between race and obesity; 3) examine the impact of BMI at the time of injury on 1-year …