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Hippocampal Ca1 Dentation And Its Relationship With Episodic Memory In Healthy Children, Julia Beattie Jan 2018

Hippocampal Ca1 Dentation And Its Relationship With Episodic Memory In Healthy Children, Julia Beattie

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Hippocampal dentation is a morphological feature present on the inferior surface of the human hippocampus, most clearly visible in the sagittal view in structural neuroimaging. This dissertation examines the development of hippocampal dentation during childhood and adolescence, as well as its functional relationship with episodic memory performance. Our previous work in examining hippocampal dentation in healthy adults represented the first systematic description as well as the first indication of functional significance of this feature (i.e., both verbal and visual memory performance). In this new series of studies, two large, NIH-funded databases were utilized to examine this feature in samples of …

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Immunophenotype In The Molecular Epidemiology Of Breast Cancer, Michael Behring Jan 2018

Immunophenotype In The Molecular Epidemiology Of Breast Cancer, Michael Behring

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This research analyzes the underlying genomic features of breast tumors during immune response, with the overall goal of discovering markers of how tumor immunity and the known features of disease pathology relate. We aimed to 1) identify and validate somatic copy number variation and RNA expression associated with nodal metastasis; 2) construct an array-based measure of tumor infiltrating immune cells and determine its prominent clinical and transcriptional features; and 3) examine the relationship between somatic mutations within p53 and tumor immune cell infiltration status. In two sets of data, gene-level copy number variation (CNV) and RNA expression from the primary …

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Evaluation And Comparison Of Child And Adolescent Mallampati Scores, Diana Bozner Jan 2018

Evaluation And Comparison Of Child And Adolescent Mallampati Scores, Diana Bozner

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Objectives: The purpose of this study is to investigate clinical assessments that may help to predict pediatric obstructive sleep apnea (OSA). These clinical tools include the Mallampati and Brodsky classifications, as well as the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD). The specific aims of this study are to: 1.) Compare the Mallampati scores, Brodsky scores, and results of the ESS-CHAD of children versus adolescents in order to observe how these criteria change with age. 2.) Compare the Mallampati scores derived by a dental student, an orthodontic resident and a pediatric otorhinolaryngologist (ENT) to determine the accuracy of this …

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Effects Of Medicaid Expansion On The Financial Performance Of Rural Hospitals, Keith Darryl Brady Jan 2018

Effects Of Medicaid Expansion On The Financial Performance Of Rural Hospitals, Keith Darryl Brady

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EFFECTS OF MEDICAID EXPANSION ON THE FINANCIAL PERFORMANCE OF RURAL HOSPITALS KEITH BRADY DOCTOR OF SCIENCE IN HEALTH SERVICES ADMINISTRATION ABSTRACT The purpose of this research was to examine the effects of Medicaid expansion on the financial performance of rural hospitals. The analysis compares Medicaid revenue, uncompensated care cost and operating margins between rural hospitals in states that expanded Medicaid and rural hospitals in states that did not expand Medicaid. Strategic Management Theory was used to develop a theoretical framework to address three primary hypotheses. Secondary data from the Medicare Cost Report (MCR), the Agency for Healthcare Research and Quality …

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Gender-Specific Facilitators And Barriers To Health-Related Quality Of Life In Adults With Cystic Fibrosis: A Mixed Methods Study, Leigh Ann Bray Jan 2018

Gender-Specific Facilitators And Barriers To Health-Related Quality Of Life In Adults With Cystic Fibrosis: A Mixed Methods Study, Leigh Ann Bray

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BACKGROUND: With the life expectancy of individuals with cystic fibrosis (CF) doubling over the last two decades, it is critical that healthcare providers address both quantity and quality of life. Health-related quality of life (HRQoL) encompasses physical, social, psychological, and functional aspects of daily living and how CF impacts each one. Women with CF consistently report having an overall poorer quality of life across international studies, but the cause of the gender difference is unknown. The purpose of this study was to explore gender differences in HRQoL and then build upon those results to better understand gender-specific facilitators and barriers …

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An Analysis Of The Association Between An Established Chief Experience Officer Position And Hospital Patient Experience Scores Within Three States, William Robert Breen Jan 2018

An Analysis Of The Association Between An Established Chief Experience Officer Position And Hospital Patient Experience Scores Within Three States, William Robert Breen

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Few industries operate with as much capacity to personally satisfy or disappoint, as does the U.S healthcare industry. Healthcare outcomes sought by society include wellness, safety, healing, and, ultimately, experiences. While healthcare involves complex relationships between patients, families, providers, payers, and regulators, the use of management theory can be insightful in studying and explaining the motivations and strategic decisions of healthcare managers. The healthcare industry is currently reacting to multiple stakeholders demanding improvements to the patient experience. New ways to measure patient experiences in healthcare are emerging. Some healthcare organizations are implementing new management structures, i.e., the role of Chief …

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The Effects Of Growth Hormone In Human Melanoma Cell Lines, Ashiya Buckels Jan 2018

The Effects Of Growth Hormone In Human Melanoma Cell Lines, Ashiya Buckels

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Melanoma is less common than basal and squamous cell skin cancers, but is the most aggressive form of skin cancer. ~90% of melanomas carry a mutation in the RAS-RAF pathway, which promotes progression by constitutive activation of the extracellular sig-nal-regulated kinase (ERK) signaling cascade. BRAF inhibition is an effective line of therapy for advance melanoma, but patients often progress due to the development of several forms of treatment resistance. Therapeutic resistance often results in increased invasion and migration of the cancer into proximal and distant tissues leading to the formation of metastasis. Examination of various cancer genomics data sets using …

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Nanomedicine: Electrohydrodynamic Atomization (Ehda) To Engineer Next-Generation Biomimetic Microphysiological Systems (Mps) And Precision Drug Delivery Systems (Dds), Karim Ismail Budhwani Jan 2018

Nanomedicine: Electrohydrodynamic Atomization (Ehda) To Engineer Next-Generation Biomimetic Microphysiological Systems (Mps) And Precision Drug Delivery Systems (Dds), Karim Ismail Budhwani

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Cancer is poised to become the leading cause of death worldwide with lifetime probability of 1-in-2 men and 1-in-3 women developing cancer. Despite this, research and development of new treatment options remains expensive and slow, in part, due to inadequate disease models, therapy evaluation assays, and absence of delivery control in leading treatment options. These factors also impede patient-specific personalized medicine. Electrohydrodynamic atomization (EHDA) fabrication technologies, such as electrospinning (ESp) and electrospraying (ESy), offer promising nanomedicine pathways toward addressing these challenges. ESp has garnered much interest in tissue engineering but is dwarfed by softlithography in microphysiological systems (MPS), including lab-chip …

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Investigating Driving Performance In Older Adults: A Continuum Of Mild Cognitive Impairment, Tyler Preston Bull Jan 2018

Investigating Driving Performance In Older Adults: A Continuum Of Mild Cognitive Impairment, Tyler Preston Bull

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Driving is an important instrumental activity of daily living (IADL) that is crucial for mobility and independence of adults in the United States. Dementia and cognitive impairment are indicated as increasing risk for driving impairment and cessation, prompting the necessity for screeners in predicting impaired driving performance. The Trails Making Test (TMT) A and B, and the Useful Field of View (UFOV) are common measures used to predict driving performance across populations of older adults. Prior research has shown that Mild Cognitive Impairment (MCI), which is theorized as an intermediary between normal aging and dementia, is associated with subtle declines …

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Religiosity And Spirituality As Predictors Of Substance Use In Patients With Cystic Fibrosis, Benjamin Edwin Burgess Jan 2018

Religiosity And Spirituality As Predictors Of Substance Use In Patients With Cystic Fibrosis, Benjamin Edwin Burgess

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Cystic fibrosis (CF) is a degenerative chronic illness that results in pulmonary and gastrointestinal impairment. Because health-related behaviors, such as substance use, impact health outcomes in this population, it is important to understand factors that predict substance use in patients with CF. Thus, this study aimed to examine the unique roles of spirituality and religiosity in alcohol, tobacco, and marijuana use. Higher religiosity was expected to predict lower substance use directly, reflecting a direct regulation of health behavior. Higher spirituality was expected to predict less substance use through lower depression, reflecting an indirect regulation of health behavior through emotion regulation. …

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The Relationship Among Nurse-Physician Collaboration And Outcomes: Influence Of Nursing Leadership, Tiffany Lebano Cabibbo Jan 2018

The Relationship Among Nurse-Physician Collaboration And Outcomes: Influence Of Nursing Leadership, Tiffany Lebano Cabibbo

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Background: Hospitalized patients outcomes are impacted by many professionals, with registered nurses and physicians being the most predominant. Nurses and physicians represent different autonomous professions, but their interdependent relationship effective collaboration for patients to receive high-quality and safe care. Nurse-physician collaboration is a key behavior that must be fostered by hospital leadership to meet or exceed value based outcomes (safety and quality). The purpose of this study was to examine the Chief Nursing Officer’s (CNO) perception of nurse-physician collaboration and its influence (mediating affect) on their direct reports (Nurse Directors). Furthermore, this study examining the relationship of this influence and …

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Examination Of Communication Patterns And Satisfaction Between Systems Of Care Among Parents Of Concussed Youth, Sarah Terry Cable Jan 2018

Examination Of Communication Patterns And Satisfaction Between Systems Of Care Among Parents Of Concussed Youth, Sarah Terry Cable

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When a child or adolescent sustains a concussion, several systems of care become involved (e.g., family, medical, school, sports/recreation). To effectively manage a concussion, all systems of care need to work together to maximize recovery for return-to-play (RTP) and return-to-learn (RTL). Thus, good communication and coordination of care is critical. The objectives of this study were to prospectively examine parent communication patterns (type, frequency, topic, and overall parent satisfaction with communication) with systems of care from the time of their child’s concussion up to 14 weeks past injury. Barriers to communication and parent satisfaction with overall concussion management by each …

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Multimodal Imaging (Fmri Bold Task, Functional Connectivity & Spectroscopy) Longitudinal Analysis Of Antipsychotic Treatment Effects In Unmedicated Patients With Schizophrenia, Elyse Cadena Jan 2018

Multimodal Imaging (Fmri Bold Task, Functional Connectivity & Spectroscopy) Longitudinal Analysis Of Antipsychotic Treatment Effects In Unmedicated Patients With Schizophrenia, Elyse Cadena

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Schizophrenia is a mental disorder that affects around 1% of the world’s population. Antipsychotic medication does not effectively treat all symptoms as around 1/3 of those diagnosed will remain unresponsive to treatment. Patients with schizophrenia (SZ) present dysfunction in cognitive control processes compared to healthy controls (HC). Neuroimaging SZ studies report abnormalities in brain function and neurochemistry, although the majority of these studies involve medicated patients. To better determine SZ brain abnormalities, it is vital to characterize brain function without the confounding effect of antipsychotic medication, determine the extent of medication’s effects on brain function, and the relationship with symptom …

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On The Inside: Evaluating Arts Education Programs In Prisons, Natalie Rae Campbell Jan 2018

On The Inside: Evaluating Arts Education Programs In Prisons, Natalie Rae Campbell

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Prison-arts programs are those that provide hands-on art education to inmates in correctional facilities. This study examines the prevalence of such programs throughout the United States as well as the effects that they have on inmates who participate in art education within a correctional facility. The project’s purpose raises questions about the efficacy of rehabilitative education and about how this type of education is funded and sustained. The research presented provides an insight into how many people prison-arts programs serve, at what frequency, and under what conditions classes are taught, as well as outside perceptions on the improvement of quality …

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The Evolving Landscape Of Mechanical Circulatory Support In The United States: Observations From National Registries, Ryan Segler Cantor Jan 2018

The Evolving Landscape Of Mechanical Circulatory Support In The United States: Observations From National Registries, Ryan Segler Cantor

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Mechanical circulatory support (MCS) is a rapidly evolving field. This dissertation describes trends in patient selection, device utilization, and outcomes for adult and pediatric patients receiving MCS in the United States by examining data from two national registries. Trends in adult MCS device recipients and their support outcomes were evaluated using data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS), a national registry collecting detailed information for patients implanted with Food and Drug Administration (FDA)-approved durable MCS devices. Between June 2006 and December 2016, INTERMACS enrolled more than 19,000 patients. During this time, the widespread use of devices …

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Mitochondria-To-Nucleus Retrograde Signaling And Its Role In Cancer, Trevor Carden Jan 2018

Mitochondria-To-Nucleus Retrograde Signaling And Its Role In Cancer, Trevor Carden

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Mitochondrial dysfunction is considered a hallmark of cancer. Mitochondria are essential, cellular organelles that participate in processes including energy production, calcium homeostasis and steroid metabolism. Mitochondria have been more recently appreciated for their role in cellular signaling, bringing about a greater understanding of their role in many diseases including cancer. Retrograde signaling is a mechanism by which the nucleus responds to mitochondrial dysfunction by modulating its own transcriptional programs to maintain metabolic and cellular processes. Many genes have already been identified as participants in or mediators of this signaling mechanism; these include cell signaling, metabolic and structural genes as well …

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Relationship Between Parenting Styles, Parenting Behaviors, And Children's Socioemotional Development: A Longitudinal Study, Shannon Michelle Oram Wittig Jan 2018

Relationship Between Parenting Styles, Parenting Behaviors, And Children's Socioemotional Development: A Longitudinal Study, Shannon Michelle Oram Wittig

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The relationships between self-reported parenting styles and observed parenting behaviors with socioemotional behaviors in infants (temperament) and toddlers (behavior problems) were investigated in a longitudinal, cross-lagged design. Both mothers and fathers participated in a prospective longitudinal study, beginning prenatally followed by re-assessments when children were 6 months and 18 months of age. Parents provided self-reports of their parenting styles at all three time points; in the last two time points, parents engaged in an observed structured parent-child interaction and reported on their children’s temperament at 6 months and behavior problems at 18 months. Results suggest that parenting styles remain stable …

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Assessing The Comparative Effect Of Tocilizumab On Risk Of Cardiovascular Disease Among Rheumatoid Arthritis Patients Using Claims Data: A Direct Comparison Among Biologic Disease-Modifying Antirheumatic Drugs, Fenglong Xie Jan 2018

Assessing The Comparative Effect Of Tocilizumab On Risk Of Cardiovascular Disease Among Rheumatoid Arthritis Patients Using Claims Data: A Direct Comparison Among Biologic Disease-Modifying Antirheumatic Drugs, Fenglong Xie

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ASSESSING THE COMPARATIVE EFFECT OF TOCILIZUMAB ON RISK OF CARDIOVASCULAR DISEASE AMONG RHEUMATOID ARTHRITIS PATIENTS USING CLAIMS DATA: A DIRECT COMPARISON AMONG BIOLOGIC DISEASEMODIFYING ANTIRHEUMATIC DRUGS FENGLONG XIE PhD-EPID ABSTRACT Tocilizumab is a humanized monoclonal anti-body against the interleukin-6 receptor and is effective in the treatment of rheumatoid arthritis (RA) [1]. Multiple studies have observed unfavorable changes in the lipid profile of tocilizumab-treated RA patients. Few studies have compared the cardiovascular disease (CVD) risk associated with tocilizumab to other biologic disease-modifying antirheumatic drugs (bDMARDS). Due to limitations in existing studies, the real-world association of tocilizumab with CVD risk remains uncertain. …

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Novel Anti-Cancer Therapy Development Using Omics Guided Rational Cell Process Engineering, Ningning Xu Jan 2018

Novel Anti-Cancer Therapy Development Using Omics Guided Rational Cell Process Engineering, Ningning Xu

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Cancer is one of the leading causes of mortality globally, and multiple anti-cancer therapies have been developed and applied over last few decades. Antibody-based cancer therapies have been on one of the most exciting and promising therapeutic strategies. Monoclonal antibodies (mAbs) can control the progression of cancers via targeted binding to the specific antigen of tumors to trigger an immune response, target and block the signaling pathway involved in cancer progression, or deliver cytotoxic agents into tumors. Two chimeric/humanized monoclonal antibodies (anti-HER2 mAb and anti-CD 20 mAb) with higher efficacy were successfully expressed in engineered Chinese Hamster Ovary Cells (CHO). …

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Cigarette Smoking Among Hiv-Positive Patients In Routine Clinical Care, Cosmas Mudenda Zyambo Jan 2018

Cigarette Smoking Among Hiv-Positive Patients In Routine Clinical Care, Cosmas Mudenda Zyambo

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People living with HIV (PLWH) are two to three times more likely to be current smokers, less likely to quit smoking and more likely to relapse than those in the general population. Although smoking status, prescription of smoking cessation medications (SCMs), smoking cessation and relapse has been explored in this population, few have investigated using a large sample of PLWH receiving routine HIV care. Using data from a large observational cohort of PLWH receiving routine care in Birmingham, we determined: 1) Factors associated with smoking status; 2) Factors associated with prescription of SCMs; 3) Predictors of smoking cessation and; 4) …

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Mechanistic Connections Between Metabolic And Differentiation Programs In T Cells, Danielle Alexandria Chisolm Jan 2018

Mechanistic Connections Between Metabolic And Differentiation Programs In T Cells, Danielle Alexandria Chisolm

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Cellular metabolism is closely coupled to differentiation gene programs in many developmental systems. In part, this is due to a similar complement of transcription factors playing dual roles in regulating both the gene expression programs associated with specific metabolic pathways and the differentiation gene program of the cell. In T cells, T cell receptor- (TCR) and IL-2-sensitive transcription factors coordinate the programming of metabolic states with the effector and memory gene programs. Currently, our understanding of the mechanisms by which metabolic states contribute to the regulation of T cell differentiation gene programs is unclear. Metabolites are directly involved in epigenetic …

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Adiposity And Health In Zoo African And Asian Elephants, Daniella Chusyd Jan 2018

Adiposity And Health In Zoo African And Asian Elephants, Daniella Chusyd

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African (Loxodonta africana) and Asian (Elephas maximus) elephant populations are rapidly declining due to poaching, and habitat fragmentation and loss. Due to the precarious situation elephants are facing worldwide, captive elephant populations are being viewed as an insurance policy against extinction. Unfortunately, captive elephant populations are not self-sustaining, in part because of reproductive and health issues. One hypothesis for the observed reproductive and health issues is zoo elephants are obese. The current method of assessing obesity in elephants is based on a qualitative visual tool, the body condition score, which does not quantify fat mass. The purpose of this dissertation …

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Sleep Disturbances In Children With Autism Spectrum Disorder, Christian Clesi Jan 2018

Sleep Disturbances In Children With Autism Spectrum Disorder, Christian Clesi

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Autism Spectrum Disorder (ASD) is a neurodevelopmental disability characterized by impairments in social communication and restricted and repetitive patterns of behavior, interests, or activities (American Psychiatric Association, 2013). Children with autism may also have associated symptoms; one of the most prevalent being sleep disorders, with estimated prevalence rates ranging from 40 to 80% (Goldman, McGrew, Johnson, Richdale, Clemons, & Malow, 2011). Measuring sleep disturbances in this population can be particularly challenging due to the symptoms of the disorder, including impairments in communication. Therefore, research in this field regularly relies on parent-report data to measure sleep disturbances in children with ASD. …

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Discovering The Needs Of Parents: A Look Into Parenting Needs In A Southeastern Suburb, Sarah Elizabeth Cole Jan 2018

Discovering The Needs Of Parents: A Look Into Parenting Needs In A Southeastern Suburb, Sarah Elizabeth Cole

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Parental self-efficacy (PSE) and parental discipline practices greatly determine the parent-child relationship and the effects of child anti-social behaviors. This research provides a look into parenting practices within a Southeastern school district implementing a Comprehensive Integrated Three-Tier Model of Support (Ci3T). Data from this research shows that parental self-efficacy does correlate with the level of student support services (IEP, 504 Plan, tiered interventions, and gifted programs) a child is enrolled in. Although this research proves to be significant to this population, future research would benefit from expanding the study population to include parents who are fathers, those with a lower …

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Neuropeptide Y Cells Regulate Anxiety Behavior, Katelynn Corder Jan 2018

Neuropeptide Y Cells Regulate Anxiety Behavior, Katelynn Corder

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Dysregulation of the GABAergic system has long been implicated in anxiety disorders. Classic anxiolytic drugs, such as benzodiazepines, increase GABAergic transmission by modulating GABA¬A receptors, relieving anxiety symptoms. However, these treatments are not always effective and are often accompanied by negative side effects. Glutamate decarboxylase (GAD) is the enzyme responsible for producing GABA. Recent studies have shown that when the isoform GAD67 is reduced in specific brain regions or GABAergic subtypes, differential anxiety effects were found. These studies suggest that targeting specific GABAergic cell subtypes may provide a more effective treatment for anxiety disorders. Neuropeptide Y (NPY) is an abundant …

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Interorganizational Relationships And Hospital Adoption Of Surgical Robots, Stephen Cullen Jan 2018

Interorganizational Relationships And Hospital Adoption Of Surgical Robots, Stephen Cullen

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INTERORGANIZATIONAL RELATIONSHIPS AND HOSPITAL ADOPTION OF SURGICAL ROBOTS STEPHEN G. CULLEN EXECUTIVE DOCTORIAL PROGRAM IN HEALTHCARE LEADERSHIP ABSTRACT The study investigates the relationship between interorganizational relationships (IORs) and hospital adoption of robotic surgery in the United States over a ten-year period. As a competitive strategy for hospitals, IORs should matter in a hospital’s decision to adopt a surgical robot given associated costs and risks. While literature exists on IORs and technical innovation, there is a gap in the literature on IORs and hospital adoption of surgical robots. This study explores four types of IORs (i.e., networks, systems, contract management, and …

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Cheminformatic Discovery And Characterization Of Copperdependent Bacterial Inhibitors, Alex Dalecki Jan 2018

Cheminformatic Discovery And Characterization Of Copperdependent Bacterial Inhibitors, Alex Dalecki

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Deaths due to antibiotic-resistant bacteria are predicted to exceed 10 million per year by 2050, endangering our ability to conduct fundamental medical procedures such as immunosuppressive therapy or even basic surgery. Unfortunately, we are largely falling behind in the evolutionary arms race against common pathogens. Not only are we in sore need of new antibiotics, we also evidently need altogether new approaches to drug discovery itself, as our familiar avenues are increasingly failing to meet demands. In this dissertation, we describe a promising new source of antibacterials: copper-dependent inhibitors (CDIs), compounds that exert significant antibiotic activity only in the presence …

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Effects Of Dietary R,S-1,3 Butanediol Diacetoacetate On Components Of Energy Balance, Rachel A H Davis Jan 2018

Effects Of Dietary R,S-1,3 Butanediol Diacetoacetate On Components Of Energy Balance, Rachel A H Davis

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Ketogenic diet (KD) has been used to attenuate the decline in energy expenditure occurring from calorie restriction-induced weight loss, but long-term adherence can be difficult due to the strict nature of the diet. The growing body of evidence supporting KD-treatment of neurologic and metabolic diseases, as well as obesity, has prompted interest in the ability to increase circulating ketones via exogenous delivery. Ketone esters (KE) can raise blood ketone concentrations similarly to fasting and appear to reduce food intake acutely, but studies assessing effects on energy balance are limited and provide a potentially promising direction for weight control. Previous investigations …

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Functional Analysis Of Cdc45 In The Replication Fork And In Response To Replicative Stress, Amanda Debrot Jan 2018

Functional Analysis Of Cdc45 In The Replication Fork And In Response To Replicative Stress, Amanda Debrot

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DNA replication is a highly conserved and tightly regulated process, with a variety of factors acting to ensure faithful duplication and stability of chromosomal DNA. During replication, positive supercoils form ahead of the advancing replication fork. DNA topoisomerase 1 (Top1) acts to prevent DNA damage by relieving the torsional strain created by these supercoils. The camptothecin (CPT) class of chemotherapeutics target Top1, creating a long-lived DNA-Top1-CPT covalent complex, which leads to S-phase specific DNA lesions and cellular death. Our lab previously performed a genetic screen to isolate mutant proteins that enhance cell sensitivity to Top1-mediated DNA damage. One of the …

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Investigating Instructional Practices Of Pre-K Teachers And How It Influences A Child's Readiness For Kindergarten, Dorielle Dixon Jan 2018

Investigating Instructional Practices Of Pre-K Teachers And How It Influences A Child's Readiness For Kindergarten, Dorielle Dixon

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The purpose of this qualitative study was to investigate the significance of how pre-kindergarten teachers implement instruction to prepare children for kindergarten. The study was guided by the research question: What instructional practices are preschool teachers implementing towards the support, preparations, and instruction they are implementing to shape children for kindergarten? This research study sought to answer four sub-questions. First, what do pre-k teachers report as instructions they use to prepare children for kindergarten? Second, how are pre-k teachers implementing their instruction to prepare children for kindergarten? Third, how does the pre-k program prepare the children for the rigor of …

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