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The Effects Of Direct To Consumer Advertising On Healthcare Utilization Among Medicaid Children With Asthma, Luceta C. Mcroy

All ETDs from UAB

National guidelines recommend treatment of asthma with preventive long term medication, but adherence remains low, resulting in high healthcare utilization among those affected by the chronic disease. The increase in DTCA since the easing of restrictions by the FDA in 1997 has prompted much debate on the effects of the DTCA, with critics arguing that it is harmful while proponents see many benefits such as increased medication adherence. This study examines the impact of DTCA on healthcare utilization and asthma medication use by combining Medicaid administrative data and a national advertising data set on asthma medication from 1999 to 2002. …

A Study Of Early Adopters Of Innovation, John B. Mcwhorter

All ETDs from UAB

This research study focused on identification of environmental and organizational variables that influence the rate of adoption of administrative innovation in organizations, and specifically hospitals that have adopted nurse magnet programs. The study identified both organizational and environmental factors as statistically significant among early adopters of magnet programs in hospitals, with organizational influences stronger than environmental influences in determining the rate of adoption of innovation. Organizational complexity, size, control of domain, presence of a competitor, and available resources were the factors identified as influencing the early adoption of innovation among hospitals.

Socioeconomic Patterning Of Obesity Among African American Women In The Jackson Heart Study, Tonya Moore

All ETDs from UAB

Objectives: The purpose of this study was to expand upon what has been observed in literature about obesity and its ties to socioeconomic status (SES) among African American Women (AAW) participants of the Jackson Heart Study (JHS). Methods: This secondary analysis was a sub-study of the JHS and focused on four SES variables: education, income, occupation and wealth; and five outcome variables: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Two analytic samples were created in order to examine data collected during Exam 1 (2000-2004) and Exam 2 (2005-2008). …

A Repeated Measures Quantitative Prospective Inquiry Into The Change In Medical Student Self-Reported Empathy In Clinical Rotations, Kristina T C Panizzi Woodley

All ETDs from UAB

This dissertation study examined whether or not there were quantitative changes in medical student self-reported empathy scores over time and across gender within third- and fourth-year cohorts enrolled in an integrated curriculum at a Southeastern U.S. medical school. The dependent variable was quantitative empathy scores at time 1 and time 2 using the Jefferson Scale of Empathy (JSE, medical student S-Version). Primary independent variables were cohort year and gender. Variables of clinical campus site, rotation orientation category, and specialty interest orientation category were also explored. The study found that empathy increased for the third-year complete cohort but decreased for the …

Using Mouse Models To Investigate Ciliopathies, Raymond Carl Pasek

All ETDs from UAB

Cilia and flagella are microtubule based organelles found on nearly every cell type in the mammalian body. Flagella have an essential role in sperm locomotion and reproduction, while motile cilia have a known role in fluid movement in the brain, lungs, and portions of the female reproductive tract. While the role of most primary cilia remained unknown for decades, they are now recognized as being essential to mammalian development, renal homeostasis, and satiety, just to name a few. Because of their widespread presence and importance, dysfunction of cilia and flagella can lead to a variety of human diseases, collectively referred …

Aga Khan University, Report 2012, Aga Khan University

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Targeting Mitochondrial Function In Diabetic Nephropathy, Colin Reily

All ETDs from UAB

TARGETING MITOCHONDRIAL FUNCTION IN DIABETIC NEPHROPATHY The incidence of diabetes has increased to epidemic proportions over the last 50 years, due to a complex interaction of lifestyle and dietary factors. Changes in physical activity, caloric intake, and the composition of foods consumed over the last century are thought to interact with metabolic syndrome prone subpopulations leading ultimately to diabetes. It is widely accepted that chronic hyperglycemia in the blood characterizes the diabetic condition. Since the discovery of insulin therapy in the first half of the 20th century, diabetics have extended their lifespan considerably, but at the cost of increased morbitity …

Molar Distalization To Resolve Class Ii Malocclusion: A Cephalometric Study Utilizing The Carriere Distalizer, Careybeth Hayes Rivers

All ETDs from UAB

Objective: The purpose of this study is to determine the short-term skeletal and dental effects that occur as a result of Class II malocclusion correction utilizing the Carrière Distalizer as compared to best-matched controls. Methods: This is a retrospective cohort cephalometric study using lateral cephalometric films of 25 (14 male, 11 female, average age 13y 6m) class II patients consecutively treated with the Carrière Distalizer compared with 36 (19 male, 17 female, 13y 2m) untreated class II control subjects from a historical database best-matched based upon age, sex and skeletal classifications. Pretreatment and posttreatment lateral head films were analyzed with …

Cystine/Glutamate Transporters As Prognostic & Therapeutic Markers Of Primary Brain Tumors, Stephanie Marie Robert

All ETDs from UAB

Glioblastoma multiforme (GBM) are the most prevalent and aggressive malignant brain tumors. Current treatment - a combination of radiation, chemotherapy and resection - has limited effectiveness and offers poor prognosis. In this study, we examined the roles of system xc- (SXC) and excitatory amino acid transporters (EAATs), which transport the amino acids cystine and glutamate, on tumor growth, neurotoxicity, and peritumoral seizure activity. Tissue micro-arrays from 45 patients were examined by immuno-histochemistry, comparing tumor-bearing tissue and adjacent normal brain. Using a novel flank tumor propagation technique, we chose 3 glioma samples with varying SXC and EAAT expression levels to study …

Factors Associated With Participant Retention In A Behavioral Weight Loss Study, Cathy C. Roche

All ETDs from UAB

Participant retention in longitudinal research is gaining increasing attention. By identifying factors associated with participant retention, programs can be better designed to promote effective weight loss. This study examines factors associated with participant retention. The Anderson Behavioral Model provided the conceptual framework for the study. The sample consisted of secondary data abstracted from the research records of 316 participants in the University of Alabama at Birmingham cohort of the Look Action for Health in Diabetes (AHEAD) trial. The Look AHEAD trial is a randomized controlled trial designed to investigate the long-term effects of interventions aimed at producing weight loss in …

Studies In Public Health Systems And Services Research: Three Papers Examining The Market Environment, Quality Improvement, And Community Partnerships, Valerie A. Yeager

All ETDs from UAB

This dissertation, comprised of three publishable manuscripts, addresses various identified gaps in the literature focused on public health systems and services research. Public health systems and services research includes studies that examine the organization, financing and delivery of public health services in communities, and the impact of these services on public health. Specifically, this dissertation focuses on three topics: (1) the measurement of the health care market environment of local public health departments, (2) community characteristics related to quality improvement strategies in local public health environments, and (3) the longitudinal changes in public health partnerships and how these partnerships relate …

Transcriptional Regulation Of Gfap, Sujeong Yeo

All ETDs from UAB

Glial fibrillary acidic protein (GFAP) is an astrocytic intermediate filament protein whose levels are increased in response to CNS injuries. Aim one of my thesis is to find the regulatory elements of the GFAP promoter responsible for its expression properties using a transgenic approach, since previous studies showed inconsistent results between in vitro and in vivo approaches. Two contiguous DNA segments previously implicated in transcriptional control of the GFAP gene, the B region (bp -1612 to -1489), and the C1.1 and C1.2 regions (bp -1488 to -1399), were analyzed. Block mutation of each of 4 contiguous sequences together spanning the …

Fcrl5 Exerts Binary And Compartment-Specific Influence On Innate-Like B Cell Receptor Signaling, Zilu Zhu

All ETDs from UAB

Innate-like splenic marginal zone (MZ) and peritoneal cavity (PEC)-derived B1 B lymphocytes are the major contributors to primary humoral responses and play an important role in connecting innate and adaptive immunity, but are known to significantly differ in their B cell receptor (BCR) signaling characteristics. In mice, FCRL5 is discretely expressed by innate-like MZ and B1 B cells and is furthermore equipped with cytoplasmic ITAM-like and ITIM elements, suggesting diverse signaling potential for it. Our results showed that FCRL5 markedly inhibited BCR-mediated activation in MZ B cells, but not in PEC B1 B cells. To characterize its signaling function, a …

Clinical Evaluation Of Treatment Of White Spot Lesions With Icon, Candace A. Cronan

All ETDs from UAB

Introduction: Despite an increased awareness by clinicians and their attempt to aid patients in the prevention of white spot lesions, enamel demineralization continues to be a problem associated with orthodontic treatment. Current treatment options for these unaesthetic scars on the teeth range from conservative options for remineralization such as the use of fluoride and CPP-ACP to more aggressive treatment involving loss of tooth structure with microabrasion or restorations. An innovative option for treatment has recently been introduced in the form of the infiltrant resin, Icon. Icon infiltration is a minimally invasive procedure performed by a dentist that is claimed to …

Three-Dimensional Magnetic Resonance Imaging Of The Natural Dentition, Ryan Jeffery Cox

All ETDs from UAB

The purpose of this study was to determine if ultra short echo time magnetic resonance imaging (UTE-MRI) technology could be used to image teeth in orthodontics. The objectives of this study were to determine the accuracy and resolution of UTE-MRI on dental morphology and its application to the field of orthodontics with respect to appliance affect on morphology. Teeth were collected from the Orthodontic clinic at the University of Alabama at Birmingham and the Institutional Review Board of the University of Alabama at Birmingham approved the study. High-resolution 3-Tesla UTE-MRI was preformed on sixty extracted human premolar teeth with fixed …

Analysis Of Ergothioneine Production In Mycobacterium Tuberculosis, Loni Ann Guidry

All ETDs from UAB

Mycobacterium tuberculosis (Mtb), the etiological agent of tuberculosis, currently infects more than two billion people worldwide. Mtb is a highly adaptable pathogen, capable of modifying its metabolism in response to its environment. We previously showed that Mtb WhiB3 is a redox-responsive regulator of core intermediary metabolism and lipid anabolism through which it maintains redox homeostasis. In this work, through the use of metabolomic analysis and a novel radioactive thin layer chromatography assay, we discovered that WhiB3 regulates the production of the intracellular thiol ergothioneine (ergo) when using immunomodulatory lipid precursors as the major carbon source. Our results suggest that this …

The Role Of Histone Methylation In The Medial Temporal Lobe During Long-Term Memory Formation, Swati Gupta

All ETDs from UAB

Several studies have established the importance of epigenetic regulation of gene transcription in the brain during memory consolidation. Epigenetic mechanisms involve modifying the DNA or the associated histone proteins to determine the transcriptional outcome of a gene. The work encompassed in this dissertation serves as an initial investigation for the role of histone lysine methylation mechanisms in regulating gene activation and suppression in the medial temporal lobe that includes entorhinal cortex (EC), hippocampus, and amygdala during memory consolidation. To this end, we found that di-methylation of histone H3 at lysine 9 (H3K9me2) which promotes gene suppression was specific to associative …

The Role Of Vpr-1 Msp Signaling In C. Elegans, Sung Min Han

All ETDs from UAB

In C. elegans, the major sperm protein (MSP) is the most abundant protein in sperm and functions as an intracellular cytoskeleton protein and a secreted extracellular signal that induces oocyte maturation and sheath contraction. Evolutionarily, MSP domain-containing proteins originate from the VAPs (VAMP/synaptobrevin-associated proteins), which comprise a highly conserved protein family with an MSP domain at the N-terminus and a transmembrane domain at the C-terminus. I have been studying the signaling role of VAP MSP domains using the C. elegans model system. In collaboration with Hugo Bellen's lab at Baylor College of Medicine, we have shown that C. elegans, Drosophila, …

Diagnostic Classifications For Bipedal Locomotion, Lois Deming Hedman

All ETDs from UAB

Background: Analysis of and intervention for movement dysfunction, especially walking dysfunction, is the central expertise of physical therapists (PTs). PTs are called to establish a diagnosis prior to making patient management decisions yet no valid classification system for walking exists. Objectives: The purpose of this study was to determine if locomotor experts could arrive at consensus on the validity, mutual exclusivity and understandability of diagnostic classifications for bipedal locomotion. Methods: An electronic mail Delphi survey methodology was utilized. Experts were recruited purposefully through research and clinical leaders in the PT profession. Identified experts were then asked for their recommendations in …

High-Risk Human Papillomavirus And Cervical Intraepithelial Neoplasia Among Foreign-Born Latinas At Colposcopy, Bertha Hidalgo

All ETDs from UAB

Although the literature is quite extensive with regard to the human papillomavirus (HPV) among many racial/ethnic populations, there continues to be a paucity of information regarding the prevalence of HPV types as well as of cervical intraepithelial neoplasia (CIN among Latinas, specifically foreign-born Latinas. Some studies have reported prevalence of HPV among Latinas, but very few have differentiated between US- and foreign-born Latinas. This nuance is essential to understanding the true effect contributed by each group to HPV and CIN incidence and prevalence rates. Therefore, this dissertation aimed to assess differences in the prevalence of high- and low-risk types and …

Effect Of Childhood Obesity On Risk Of Pelvic Bone Fracture In Simulated Sideways Fall, Min-Heng Hsieh

All ETDs from UAB

Since the number of obese children in the U.S. has been increasing, the question arises whether obese children could be at higher or lower risk compared to nonobese children. The objective of this research was to investigate the risk of pediatric pelvic bone fracture in sideways falls using computational modeling and simulation considering various levels of obesity. Two sets of models were developed and tested. The first set was body component models. Several 10-year-old pelvis-femur complex models were developed. The models included biological soft tissue layers to reflect various levels of obesity, and they were validated against published experimental data. …

Mitochondrial Morphology And Function In Neuronal Cells Under Stress, Lonnie Schneider

All ETDs from UAB

Neurodegenerative disease encompasses a wide range of conditions and pathologies that can manifest at any age depending on the etiology. A major factor in both early onset and age-related neurodegeneration is mitochondrial dysfunction. To investigate how mitochondrial bioenergetics is affected by cellular stress, we used an in vitro culture system to examine mitochondrial function in response to oxidative stress. We also studied an in vivo model of neuronal ceroid lipofuscinosis to determine the impact of deficient autophagy-lysosomal activity on mitochondrial morphology, composition and function. In vitro we found that retinoic acid-induced differentiation of dopaminergic neuroblastoma SH-SY5Y cells exhibited increased mitochondrial …

Early-In-Life Bladder Inflammation Alters Kappa-Opioid Modulation Of Inflammatory Bladder Pain, Amber Dianne Shaffer

All ETDs from UAB

In adult female rats, zymosan-induced inflammation of the bladder leads to bladder hypersensitivity, as reflected in augmented visceromotor reflex (VMR) responses to urinary bladder distension (UBD). Prior early-in-life (EIL) experience with bladder inflammation further increases bladder hypersensitivity. Naloxone increases bladder hypersensitivity in animals inflamed only as adults, but not in animals inflamed EIL, indicating that bladder inflammation recruits an inhibitory opioid system which may be impaired by EIL inflammation. This thesis examined what role the dynorphin/κ-opioid system played in mediating bladder hypersensitivity through the impairment of opioid inhibition. In all experiments, animals were treated EIL (P14-P16) and as adults with …

Screening For Medical Referral: Determining Variables That Influence Accuracy, Heather Ellis Mount

All ETDs from UAB

SCREENING FOR MEDICAL REFERRAL: DETERMINING VARIABLES THAT INFLUENCE ACCURACY HEATHER E. MOUNT DOCTOR OF SCIENCE IN PHYSICAL THERAPY ABSTRACT Background: Screening for medical referral is essential to autonomous practice; however, no studies have examined the medical screening abilities of physical therapists in various settings. Objective: The purpose of this study was to determine if physical therapists in various practice settings could appropriately screen for medical referral, given brief clinical vignettes. Methods: A Delphi study was performed to enhance the content validity of the vignettes. After reviewing the vignettes, survey participants determined if they would provide intervention, provide intervention and refer, …

Innate Immune Mechanisms Against The Atypical Fungal Pathogen Pneumocystis Murina, Michael Paul Nelson

All ETDs from UAB

Pneumonia caused by the fungal pathogen Pneumocystis continues to be the leading cause of morbidity and mortality in AIDS patients. In addition, there are a number of other non-HIV-associated diseases that render an individual susceptible to Pneumocystis infection, including chronic obstructive pulmonary disease. Innate immune mechanisms are important for controlling Pneumocystis lung infection. As alveolar macrophages serve the front lines of lung host defense, our goal was to elucidate their responses during lung Pneumocystis infection. Here, we established a role for Src family kinases in the lung immune response to Pneumocystis, which uncovered a role for alternatively activated alveolar macrophages. …

Electrophysiological Investigation Of Rabbit Retinal Ganglion Cells, Przemyslaw Nowak

All ETDs from UAB

The retina is the first stage of the visual system, responsible for transducing light into the neural signal and for subsequent processing of this signal before sending it to the higher visual centers in the brain. The output to the higher visual centers is mediated by retinal ganglion cells, which not only relay the signal, but also substantially contribute to its processing. Depending on what computations they perform, they are subdivided into different types. These cells have been extensively studied in various spices, one prominent example being the rabbit. In rabbits, one characteristic type comprises On-Off directionally selective retinal ganglion …

Association Between Cc Chemokine Ligand 3-Like-1 (Ccl3l1) Gene Copy Number And Rheumatoid Arthritis In African Americans, Mawuli Kwame Nyaku

All ETDs from UAB

Gene copy number of the CC Chemokine ligand 3-Like-1 (CCL3L1) located on chromosome 17 position q12 varies between ethnicities. Previously, gene copy number of CCL3L1 greater than the ethnic median copy has been associated with an increased risk of Rheumatoid Arthritis. Three later studies found no association between CCL3L1 and RA. All studies were conducted in non-African Americans and an objective of this study was to determine this association in an African American cohort. CCL3L1 shares significant homology with three other genes within the same cluster; CC Chemokine ligand 3 (CCL3), CC Chemokine ligand 3-Like-2 (CCL3L2) and CC Chemokine ligand …

Male Hypogonadism At A Tertiary Care Hospital In Karachi, Pakistan, Nanik Ram, Ali Asghar, Fauzan Hashmi, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Background: Male hypogonadism is defined as 'inadequate gonadal function, manifested by deficiency in gametogenesis and/or secretion of gonadal hormones'. Signs and symptoms of hypogonadism depend primarily on the age of onset. It can be classified according to the site primarily involved: the gonads, the hypothalamus, or the pituitary gland. The objective this study was to determine the presentation and aetiology of male hypogonadism seen in a tertiary care hospital.

Methods: This cross-sectional study was conducted at Endocrine Clinics, Aga Khan University Hospital Karachi. Data of male patients with hypogonadism who attended clinics during January 2009 to August 2011 were …

Thomas Jefferson University, Department Of Pathology, Anatomy And Cell Biology, Oral Administration Of Apigenin Inhibits Metastasis Through Akt/P70s6k1/Mmp-9 Pathway In Orthotopic Ovarian Tumor Model., Jun He, Qing Xu, Min Wang, Chongyong Li, Xu Qian, Zhumei Shi, Ling-Zhi Liu, Bing-Hua Jiang

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Apigenin, a flavonoid commonly present in the daily diet, is known for its potential anti-tumor properties. However, the effect of apigenin via oral administration on tumor growth and metastasis remains unknown. In this study we developed an orthotopic ovarian tumor model in nude mice to test the effect of apigenin oral administration, and showed that apigenin inhibited the micrometastasis of cancer cells in the animal tumor model. To understand the mechanism of apigenin in inhibiting metastasis, we found that apigenin greatly inhibited MMP-9 expression and p-AKT and p-p70S6K1 levels in the tumor tissues compared to the control group. We further …

Transition To Democracy In Post-Soviet States: Success Or Failure. Case Study Analysis, Ceyhun Valiyev

Khazar Journal of Humanities and Social Sciences

The democratization of Post-Soviet states in past two decades is the subject of this academic study. The main question of this research is that why most of the PostSoviet states haven’t gone through successful transition to democracy. Five countries; Azerbaijan, Belorussia, Georgia, Lithuania and Uzbekistan are the cases of this study to analyze and evaluate as empirical part of this work. I haven’t chosen the countries that have standard and equal level of success or failure. For instance, Lithuania is among those countries that have gone through quite successful process of democratization, whereas others have similar or different problems hindering …