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Comparing The Quality Of End Of Life Cancer Care In The Medicare Population Prior To And After The Enactment Of The Medicare Prescription Drug, Improvement And Modernization Act Of 2003, Rene Jooste Jan 2016

Comparing The Quality Of End Of Life Cancer Care In The Medicare Population Prior To And After The Enactment Of The Medicare Prescription Drug, Improvement And Modernization Act Of 2003, Rene Jooste

All ETDs from UAB

Reimbursement for chemotherapy could account for two thirds of the income for oncologists in private practice. The Medicare prescription drug improvement and modernization act of 2003 (MMA) brought about a dramatic change in the way physicians were reimbursed for delivering chemotherapy in an attempt to slow the skyrocketing costs of drugs and Medicare costs for covering these drugs . The MMA reduced Medicare reimbursements for covered outpatient prescription drugs from 95% to 85% of the average wholesale price. In 2005, a new payment system was instituted that reimbursed fee-for-service providers for drugs at the national average sales price plus 6%. …

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Motor Unit Remodeling During Neuromuscular Degeneration In Aging And Parkinson's Disease, Neil Anthony Kelly Jan 2016

Motor Unit Remodeling During Neuromuscular Degeneration In Aging And Parkinson's Disease, Neil Anthony Kelly

All ETDs from UAB

The human neuromuscular system deteriorates progressively with age and disease. This results in denervation events and ultimately motor unit remodeling, which is revealed by abnormal “groups” of myofibers expressing the same myosin protein isoform – a phenomenon described as myofiber type grouping. Despite the acceptance of myofiber type grouping as a hallmark indicator of motor unit remodeling, traditional techniques of detecting it lack quantitative parameters and therefore comparative data in aging and disease are scarce. The purpose of this dissertation is to establish a statistically-driven, quantitative method for detecting myofiber type grouping and to use it to characterize the effects …

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Early-Life Programming Of Emotional Behaviors And Cardiovascular Function, Samir Rana Jan 2016

Early-Life Programming Of Emotional Behaviors And Cardiovascular Function, Samir Rana

All ETDs from UAB

Extensive evidence implicates bi-directional relationship between mood disorders and cardiovascular disorders. Early-life experience can have strong effects both on emotional development and cardiovascular function throughout life. Studies in humans are limited to correlational analyses, which are necessarily limited in terms of revealing mechanistic underpinnings of these associations. Thus, various pre-clinical models are utilized to investigate the effects of early-life experience in various domains, such as behavior and cardiovascular function, which are likely mediated by epigenetic mechanisms. Previous studies have used maternal separation and neonatal handling in developing rodents as a way to model differences in early-life experience. The effect of …

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High-Intensity Interval Training With Energy Restriction Preserves Lean Tissue And Improves Glucose Tolerance In Obesity, Rachel Ann Harley Jan 2016

High-Intensity Interval Training With Energy Restriction Preserves Lean Tissue And Improves Glucose Tolerance In Obesity, Rachel Ann Harley

All ETDs from UAB

Calorie restriction (CR) reduces body weight (BW) and adiposity, but is often less than expected due to hypometabolism produced by reductions in lean body mass (LBM). A comparable energy deficit created by combining CR and exercise energy expenditure (EE) has been shown to attenuate the reduction in EE produced by CR. Continuous moderate-intensity training (MIT) is commonly used to sustain energy balance or expedite weight loss, but high-intensity interval training (HIIT) may produce greater results. The purpose of this investigation was to determine if HIIT preserves LBM and improves energy metabolism to a greater extent than MIT in the presence …

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Exploring The /Role Of The Principal In Creating A Culture Of High Academic Optimism: A Sequential Quan --> Qual Mixed Methods Study, William A. Harper Jan 2016

Exploring The /Role Of The Principal In Creating A Culture Of High Academic Optimism: A Sequential Quan --> Qual Mixed Methods Study, William A. Harper

All ETDs from UAB

ABSTRACT Principals are held accountable for the academic achievement of their students. This study addressed renewed interest in how principals can improve student achievement (SA) by improving the culture of their schools. Previous research demonstrated a positive relationship between the construct of academic optimism (AO) and SA. The purpose of this mixed methods sequential Quan  Qual research study was to understand how principals in Alabama middle schools create a culture of AO that fosters high SA. In the quantitative phase 218 Alabama schools with Grade 8 were stratified into high and low categories of SA based on the percentage …

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Changes In Quality Of Life Following Substance Use Disorder Treatment For Mentally Ill Homeless Individuals, Lauren Hayes Jan 2016

Changes In Quality Of Life Following Substance Use Disorder Treatment For Mentally Ill Homeless Individuals, Lauren Hayes

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Quality of life (QOL) is a treatment outcome for substance use disorders that has largely been overlooked. Research suggests QOL is poor among persons with substance use disorders, even following treatment, but is unclear if this is primarily attributable to substance abuse itself or other life areas. Some evidence suggests other factors are responsible for low QOL, such as psychiatric distress. This paper examined QOL, its changes following treatment, and its contributors in two substance use disorder treatment studies (Homeless IV and EARTH) among persons who are homeless with co-occurring disorders. The purpose was to evaluate whether psychiatric distress should …

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Examining The Relationship Between Surgical Profiles And Financial Performance Of Hospitals, Lucas Higman Jan 2016

Examining The Relationship Between Surgical Profiles And Financial Performance Of Hospitals, Lucas Higman

All ETDs from UAB

Hospitals operate in turbulent and complex environments with limited resources. Consequently, administrators need to understand how to best use resources and improve a hospital’s positioning in a market. Surgical services is a key operational activity for hospitals, thus, a better understanding of how these services are organized by hospitals likely has important implications for a hospital’s performance and potentially survival. Given the potential importance of surgical services to hospitals, the purpose of this study was three-fold. First, the study identified different surgical profiles of hospitals based on the type and volume of surgical services provided by hospitals. Second, the study …

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Race Effects Of Perceived Weight Status And Its Relationship With Unmet Health Care Need, Sarah B. Rutland Jan 2016

Race Effects Of Perceived Weight Status And Its Relationship With Unmet Health Care Need, Sarah B. Rutland

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This study (n=9,630) evaluates the influence of race on the relationship between perceived weight status (PWS) and obtaining health care when a respondent thought care was needed (unmet need) among young adults (age 24-34) using Wave IV of the National Longitudinal Study of Adolescent to Adult Health. Using the framework of fundamental cause, I assume that health disparities between groups is due to unequal distribution of resources between those groups that enables a group with more resources, such as wealth or race privilege, to access and support better health outcomes. I focus on race, and specifically racism, as a resource …

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Sustainable Construction With Green Compressed Earth Block (Gceb), Marwan Mostafa Jan 2016

Sustainable Construction With Green Compressed Earth Block (Gceb), Marwan Mostafa

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orthogonal predictors.

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Development Of An In Vitro, Three-Dimensional Microvasculature Model, Lauren Elizabeth Marshall Jan 2016

Development Of An In Vitro, Three-Dimensional Microvasculature Model, Lauren Elizabeth Marshall

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Vascularized in vitro models of breast cancer represent an important advance in preclinical drug testing and development. 3D in vitro tissue models are more physiologically-relevant than 2D cell culture models due to the combination of human cells and extracellular matrix (ECM) in a spatial 3D microarchitecture. Embedding a vasculature within a 3D tissue volume further increases its physiological relevance and enables paracrine cross-talk with other cell types, neovascularization and angiogenesis, size-selective permeability between blood flow and extravascular ECM, delivery of therapeutics and metabolized products to solid tumors, delivery of circulating tumor cells to metastatic sites, and production of growth-promoting and …

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The Relationship Between Hospital Interdepartmental Transfers And Patient Experience, Betty O. Mortensen Jan 2016

The Relationship Between Hospital Interdepartmental Transfers And Patient Experience, Betty O. Mortensen

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This study examined the potential relationship between interdepartmental transfers and perceptions of adult patients who were admitted and discharged from a 300-bed, not-for-profit community tertiary hospital in the Midwest. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a publically reported comparative data tool measuring hospital patient experiences. As consumers, patients are more informed about their own health and are challenging the quality and service of care provided by hospitals. The value-based purchasing reimbursement model has become a new challenge for hospitals. Historically, hospitals were reimbursed through a volume driven model. Comparatively, the value-based model focuses on …

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Boundary Construction And Identity Maintenance In Institutionalized Versus Non-Institutionalized Women Methamphetamine Users, Megan Elisabeth Webb Jan 2016

Boundary Construction And Identity Maintenance In Institutionalized Versus Non-Institutionalized Women Methamphetamine Users, Megan Elisabeth Webb

All ETDs from UAB

Since the late 1990s there has been an increase in the use of methamphetamine (meth) across the United States. Concerns about the physical, mental, and societal effects of the drug have been fueled by the media and anti-drug campaigns and have contributed to the demonization of meth and its users. People who use meth construct symbolic boundaries in an attempt to navigate the stigma associated with their drug use and in an attempt to maintain a positive self-identity. Symbolic boundaries are the distinctions, or social categories, that individuals make in attempt to categorize certain people and behaviors. One way that …

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Neural Network Associated With The Psychobiological Response To Stress, Muriah Wheelock Jan 2016

Neural Network Associated With The Psychobiological Response To Stress, Muriah Wheelock

All ETDs from UAB

The biobehavioral response to acute stress is an allostatic process. Dysregulation of the stress response has been implicated in allostatic load and the pathophysiology of a wide range of physical and psychological disorders. There have been considerable advances within the last two decades in the field’s understanding of allostatic load and a consistent finding across studies has been that individual differences are the norm rather than the exception. That is, exposure to stress seems to have minimal negative consequences for some, but substantial negative consequences for others. Determining the neural processes associated with individual differences in stress reactivity may advance …

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Mercy Otis Warren: A Woman In Motion, Victoria Courtney Roberts Jan 2016

Mercy Otis Warren: A Woman In Motion, Victoria Courtney Roberts

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This thesis is an examination of the life of Mercy Otis Warren, who wrote the first history of the United States, was the first American woman to publish political literature under her own name, and was deeply involved in politics of the Early Republic. In the time leading up to the American Revolution, Mercy wrote many plays and poems that were circulated in an effort to convince colonists of the need to break away from the British government. Her writings and political thoughts had a great influence on the shaping of the United States, yet her name is rarely found …

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Altering Metabolism In The Tumor Microenvironment To Enhance Anti-Tumor Immunity For Lung Cancer, Cara Schafer Jan 2016

Altering Metabolism In The Tumor Microenvironment To Enhance Anti-Tumor Immunity For Lung Cancer, Cara Schafer

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Overcoming cancer cell immune escape represents a fundamental obstacle in the treatment of cancer. Indoleamine 2,3-dioxygenase (IDO)-expressing myeloid-derived suppressor cells (MDSCs) are known to induce oxidative stress and alter amino acid metabolism within the tumor microenvironment (TME). The tryptophan (Trp)-catabolizing action of IDO not only promotes T cell tolerance and evasion but is also associated with impaired quality of life in cancer patients. We have previously demonstrated that a novel combination therapy, consisting of MDSC-depleting gemcitabine and a superoxide dismutase mimetic, prolonged survival of tumor-bearing mice by enhancing CD8+ memory T cell metabolism. We identify that combination therapy inhibits IDO …

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What's Up, Dut? Help, Help I'M Being Derepressed; The Great Derepression Of Sapis Or How I Learned To Stop Worrying And Love Mobilization, Rosanne Lorin Lee Hill Jan 2016

What's Up, Dut? Help, Help I'M Being Derepressed; The Great Derepression Of Sapis Or How I Learned To Stop Worrying And Love Mobilization, Rosanne Lorin Lee Hill

All ETDs from UAB

Staphylococcus aureus is known to cause disease in both human and animal populations. Many of the virulence factors important for S. aureus pathogenesis are found on mobile genetic elements known as S. aureus pathogenicity islands (SaPIs). SaPIs can transduce into surrounding cells, giving those cells the ability to produce virulence factors. Derepression allows SaPIs to be excised from S. aureus genome to initiate mobilization. Derepressors have been identified for multiple SaPIs, but it remains unknown if the same SaPI can be derepressed by multiple derepressors. It has been shown that SaPIbov1 can be derepressed by the type 1 dUTPase from …

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Examination Of 4-Hydroxy Tamoxifen- And Bh3 Mimetic-Induced Cell Death Pathways In Glioblastoma And Malignant Peripheral Nerve Sheath Tumor Cells, Christopher Dillon Graham Jan 2016

Examination Of 4-Hydroxy Tamoxifen- And Bh3 Mimetic-Induced Cell Death Pathways In Glioblastoma And Malignant Peripheral Nerve Sheath Tumor Cells, Christopher Dillon Graham

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Glioblastoma (GBM) is the most common and aggressive human primary malignant brain tumor with a 5-year survival rate of less than 5%. GBM is highly invasive, rendering complete surgical resection impossible. Additionally, this tumor type is relatively insensitive to radiotherapy. Thus, effective chemotherapeutic options present the last line of defense for GBM patients. Unfortunately, nearly 50% of all GBM tumors are resistant to the current chemotherapeutic standard, temozolomide (TMZ). TMZ is a DNA alkylating agent that promotes apoptosis via DNA damage. Resistance to TMZ-induced cell death is attributed to expression of the DNA repair enzyme O6-methylguanine-DNA methyltransferase (MGMT) resultant from …

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Volumetric Analysis Of The Lips In Aging African American And Caucasian Females, David William Bowen Jan 2016

Volumetric Analysis Of The Lips In Aging African American And Caucasian Females, David William Bowen

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The objective of this study was to perform a volumetric analysis of the lips at rest and upon smiling in African American and Caucasian females distributed throughout five age groups. Materials and Methods: Three-dimensional surface facial images of 100 African American females and 100 Caucasian females were obtained using the 3dMDTMface system (3dMDface, Atlanta GA). Images were analyzed using the Aging Evaluation Analysis (AEVA) software (Eotech, Paris, France) to assess lip volume at rest and upon smile. The following linear measurements were also calculated upon smiling and non-smiling: subnasale-stomion superius, commissure-commissure, stomion inferius-labiomental sulcus. Gingival display and crown length was …

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Neonatal Microbial Exposure And Its Effects On The B Cell Repertoire And Development Of Respiratory Allergies, Preeyam Patel Jan 2016

Neonatal Microbial Exposure And Its Effects On The B Cell Repertoire And Development Of Respiratory Allergies, Preeyam Patel

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The incidence of asthma has increased dramatically among children living in developed countries, and the hygiene hypothesis suggests that this is the result of decreased neonatal exposure to microbes. Microbes and allergens can bear similar antibody-reactive epitopes, and exposure to microbes bearing these epitopes during early life can permanently alter the frequency and clonality of the antigen-specific B cell repertoire. The objective of this dissertation was to determine if B cells stimulated by microbes during early life could suppress the development of respiratory allergies during adult life. Both Streptococcus pneumoniae (pneumococcus) and house dust mite (HDM) express antibody-reactive phosphorylcholine (PC) …

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January 1, 2016 Ereporter, University Of Alabama At Birmingham Jan 2016

January 1, 2016 Ereporter, University Of Alabama At Birmingham

eReporter (campus newsletter)

No abstract provided.

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Hospice Performance: Environmental And Organizational Correlates, Mengying He Jan 2016

Hospice Performance: Environmental And Organizational Correlates, Mengying He

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The purpose of this dissertation is to explore hospice performance using a three paper format. Based on Structure-Conduct-Performance (SCP) and Structure-Process-Outcome (SPO) models, paper 1 conducts a systematic literature review to identify gaps in hospice performance research. Paper 2 explores the relationship between hospice market structure and inpatient services provision (Structure-Conduct). Market munificence is related to hospice inpatient services offering. Organizational factors such as hospice chain-affiliation, age, and ownership also play roles in predicting hospices’ probability in providing inpatient services. Paper 3 examines the impact of hospice inpatient service provision on service utilization and financial performance (Structure-Process-Outcome). Hospices that not …

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True Reform Or Just Whistling Dixie? Child Labor Legislation And Alabama’S Progressive Governor And Cotton Mill Owner Braxton Bragg Comer, Stephanie Womack Jan 2016

True Reform Or Just Whistling Dixie? Child Labor Legislation And Alabama’S Progressive Governor And Cotton Mill Owner Braxton Bragg Comer, Stephanie Womack

Vulcan Historical Review

pp. 57-72

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Heaney At Halftime, Kieran Quinlan Jan 2016

Heaney At Halftime, Kieran Quinlan

Birmingham Poetry Review

pp. 31-38

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A Virgin Population Epidemic, Katherine Dover Jan 2016

A Virgin Population Epidemic, Katherine Dover

Vulcan Historical Review

pp. 163-168

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Section 1: Bio-Medical/Bioengineering, Ectc Coordinating Committee Jan 2016

Section 1: Bio-Medical/Bioengineering, Ectc Coordinating Committee

Early Career Technical Journal (ECTJ)

Proceedings of the 16th Annual Early Career Technical Conference, November 5, 2016. School of Engineering, University of Alabama at Birmingham, Birmingham, Alabama; pp. 1-30

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Section 3: Materials, Ectc Coordinating Committee Jan 2016

Section 3: Materials, Ectc Coordinating Committee

Early Career Technical Journal (ECTJ)

Proceedings of the 16th Annual Early Career Technical Conference, November 5, 2016. School of Engineering, University of Alabama at Birmingham, Birmingham, Alabama; pp. 63-94

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Respiratory Airflow Characteristics In Obstructed Small Airways, Jongwon Kim, Ramana Pidaparti Jan 2016

Respiratory Airflow Characteristics In Obstructed Small Airways, Jongwon Kim, Ramana Pidaparti

Early Career Technical Journal (ECTJ)

Section 1: Bio-Medical/Bioengineering; pp. 3-8

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Proceedings Of The 16th Annual Early Career Technical Conference (Complete Issue), Ectc Coordinating Committee Jan 2016

Proceedings Of The 16th Annual Early Career Technical Conference (Complete Issue), Ectc Coordinating Committee

Early Career Technical Journal (ECTJ)

Proceedings of the 16th Annual Early Career Technical Conference, November 5, 2016. School of Engineering, University of Alabama at Birmingham, Birmingham, Alabama

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Design Of A Balance Sensing System For People With Physical Disabilities Using Velostat, John M. Hoyle, Alan W. Eberhardt Jan 2016

Design Of A Balance Sensing System For People With Physical Disabilities Using Velostat, John M. Hoyle, Alan W. Eberhardt

Early Career Technical Journal (ECTJ)

Section 2: Design & Manufacturing; pp. 50-55

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On-Machine Cutting Tool Wear Monitoring Technique Based On Edge Diffraction Theory, Chabum Lee, Seongkyul Jeon Jan 2016

On-Machine Cutting Tool Wear Monitoring Technique Based On Edge Diffraction Theory, Chabum Lee, Seongkyul Jeon

Early Career Technical Journal (ECTJ)

Section 3: Materials; pp. 65-69

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