Digital Commons Network^™

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

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

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

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

All ETDs from UAB

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

All ETDs from UAB

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

All ETDs from UAB

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 …

Assessment Of Factors Affecting Quality Of Life In Oral Squamous Cell Carcinoma Patients Using University Of Washington Quality Of Life Questionnaire, Syed Abbas, Muhammad Usman Tariq, Abdul Rehman, Javeria Saeed, Syed S. Hashmi, Musa Karim, Mazhar Ali

Section of Otolaryngology, Head & Neck Surgery

Introduction Post-treatment Quality of Life (QOL) is considered an important outcome in cancer patients. A number of questionnaire tools have been designed for its assessment. University of Washington Quality of Life (UW QOL) questionnaire version four is a reliable tool for assessment of post-treatment QOL in oral squamous cell carcinoma (OSCC) patients. Our aim was to identify the post-treatment problems faced by OSCC patients and to assess the impact of clinical factors affecting post-treatment QOL by using UW QOL (version four) questionnaire. Methods The study was conducted on 59 patients with OSCC who were treated with curative intent at Patel …

Randomized Controlled Trial Of Influenza Vaccine In Patients With Heart Failure To Reduce Adverse Vascular Events (Ivve): Rationale And Design, Mark Loeb, Hisham Dokainish, Antonio Dans, Lia M. Palileo-Villanueva, Ambuj Roy, Ambuj Roy, Kamilu Karaye, Jun Zhu, Yan Liang, Gerald Yonga

Internal Medicine, East Africa

Background: Influenza is associated with an increase in the risk of cardiac and other vascular events. Observational data and small randomized trials suggest that influenza vaccination may reduce such adverse vascular events.

Research Design and Methods: In a randomized controlled trial patients with heart failure are randomized to receive either inactivated influenza vaccine or placebo annually for 3 years. Patients aged ≥18 years with a clinical diagnosis of heart failure and NYHA functional class II, III and IV are eligible. Five thousand patients from 10 countries where influenza vaccination is not common (Asia, the Middle East, and Africa) have been …

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

All ETDs from UAB

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

All ETDs from UAB

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

All ETDs from UAB

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

All ETDs from UAB

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

All ETDs from UAB

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

All ETDs from UAB

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

All ETDs from UAB

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 …

Exploring Dose Effect Of An Early Palliative Care Intervention For Advanced Heart Failure Patients, Rachel Duncan Wells

All ETDs from UAB

Heart failure (HF), a progressive condition with reduced quality of life (QoL) and high healthcare use, affects 6.5 million US adults. Research supports positive effects of palliative care integration into HF care, but there is limited consensus about the most beneficial intervention ‘dose’ (e.g. amount, duration, frequency, intensity). To date, no studies examining dose in palliative care HF interventions have been completed. Therefore, we examined dose using an existing data from the ENABLE CHF-PC trial (Educate, Nurture, Advise, Before Life Ends Comprehensive Heart Care for Patients and Caregivers; NCT02505425). Operationalizing dose as dichotomous complete/noncomplete of all intervention components (6-weekly, psychoeducational …

Characterization Of The Tgfb Pathway And Its Role In Prostaglandin Metabolism In C. Elegans, Muhan Hu

All ETDs from UAB

Cell to cell communication is fundamental to all life processes, from fertilization to death. The TGFߟ superfamily is a large family of proteins that is involved in a wide array of physiological and pathological processes, including development, wound healing, immune system function, cancer, and reproduction. This group of signaling peptides is well conserved across many organisms, from basic nematode to humans. While many studies have aimed to delineate the functions of TGFߟ, they have also unveiled the complexity of this multifunctional family of ligands. In this thesis, I take advantage of the simple C. elegans model system to study the …

The Role Of The St6gal-I Sialyltrasferase In Protecting Tumor Cells From Hypoxic Stress, Robert Brent Jones

All ETDs from UAB

An emerging concept in cancer biology is that surface glycosylation can play important roles in the regulation of cancer development and progression. Our group and others have shown that ST6Gal-I, a sialyltransferase that adds α2-6-linked sialic acids to N-glycosylated proteins, is upregulated in many cancers. Furthermore, data has indicated that ST6Gal-I acts as a pro-survival factor in a variety of settings, including resistance to chemotherapeutic drugs, radiotherapy resistance, and serum deprivation. The work presented in this dissertation adds to this understanding of ST6Gal-I’s role as a potent pro-survival factor and explores ST6Gal-I’s function in aiding tumor cells to survive hypoxic …

Bk Polyomavirus Activates The Dna Damage Response To Hijack Host Cell Cycle Control, Joshua L. Justice

All ETDs from UAB

BK Polyomavirus (BKPyV) is a DNA tumor virus that latently infects the >90% of humanity. BKPyV infection is inconsequential in healthy individuals; however, the immunocompromised carry increased risk of viral reactivation that can lead to a number of genitourinary diseases. Overall, BKPyV reactivation is a major risk factor for kidney dysfunction and failure following solid organ transplantation. There are no approved therapeutics to treat BKPyV infection, therefore studies have focused on understanding the host/virus interactions that drive infection to identify therapeutic targets. The PyV genome is small and does not encode a polymerase. Cellular transformation by the viral oncogene, T …

A Microfocal Effect In Photoreceptor Light Capture, Vasantha Kumari Kanukuntla

All ETDs from UAB

In human eyes, accomodation brings light rays into focus on the retina in order to achieve a clear images. The plane of best focus within the depth of the retina is thought to be within the photoreceptor layer, but pinpointing the exact focal position axially has not been determined. With help of adaptive optics aberration correction and its ability to have microscopic control of a retinal stimulus, we explored how sensitive human subjects are to defocus on the micron scale. We found that focal position can be reliably judged within 0.02 D, which is equivalent to about 6 microns in …

The Electronic Health Record And The Clinical Informatics Researcher: A Journey To Predicting False Positive Alerts With Patient Characteristics, Timothy Kennell

All ETDs from UAB

Since their introduction in the 1960s, electronic medical systems have brought with them tremendous opportunities and difficult challenges. In order to address patient safety, Clinical Decision Support (CDS) was added to the system, many times in the form of "pop-up" alerts. However, traditional alert typically do not incorporate enough patient-specific context resulting in inaccurate warnings. In response, clinicians override many of them. However, the high exposure to false positive alerts results in alert fatigue, a desensitization to future ones. This issue decreases patient safety by causing clinicians to ignore legitimate alerts. Despite some shortcomings, the data in modern Electronic Health …

Sexual Health Risk And Hiv Prevention: An Exploratory Study Of Behavior Among Heterosexual, African American Men And Women In Birmingham, Alabama., Kiko J. King

All ETDs from UAB

ABSTRACT The Deep South of the U.S. continues to have increased incidence of new cases of HIV since its inception, despite many advancements in HIV testing, treatment, and prevention. According to data by the CDC, rates are increasingly high among heterosexual African American (AA) men and women compared to their non-AA counterparts (CDC/HIV, 2017). In 2015, heterosexual transmission accounted for a share of new diagnoses for AA men and is the most common transmission route for AA women (KFF, 2017). The primary population affected by HIV/AIDS in Alabama is men who have sex with men (MSM) at 62.2%, followed by …

Structural And Functional Insights Into The Influenza A Virus Non-Structural Protein 1 Effector Domain, Alex Kleinpeter

All ETDs from UAB

The influenza A virus (IAV) non-structural protein 1 (NS1) is a highly multifunctional viral protein responsible for antagonizing the type-I interferon (IFN) response to infection. NS1 has therefore been identified as a potentially effective target for the development of novel anti-influenza compounds. Furthermore, it is important to understand the molecular underpinnings driving NS1 function to more effectively elucidate antiviral targets. In this dissertation, we have contributed significant insight into NS1’s potential as an antiviral target, and the structure-function relationships driving its activity in an infected cell. First, we structurally characterized the binding of two known influenza inhibitors (A9 and A22) …

Effects Of Protein Timing And Energy Balance On Body Composition In Collegiate Athletes, Ashley Licata

All ETDs from UAB

The current literature indicates that energy balance and protein consumption influence body composition. However, the effects of protein intake, timed protein supplementation, and energy balance on body composition have not yet been fully investigated in collegiate athletes. The purpose of this research was to assess collegiate athletes using hourly food and exercise data to examine how protein timing and energy balance relate to body composition. Aims 1 and 2 focus on collegiate female soccer athletes and further our understanding of the potential roles that protein amount and frequency and hourly energy balance play in optimizing fat mass and fat-free mass. …

External Root Resorption In The Orthodontic Patients, Frank Earl Litchfield

All ETDs from UAB

External Apical Root Resorption (EARR) is a side effect of orthodontic treatment that results in root shortening in about one-third of orthodontic patients. Great variability among patients exists in their susceptibility to this multifactorial condition, and both treatment and patient specific factors contribute to EARR. Root resorption values were found to be higher in Hispanics compared to Asians and Caucasians (1). However, the prevalence of EARR is not well documented in all populations. Since African Americans represent the largest minority group in the United States, establishing the prevalence and risk factors for EARR within this ethnicity is important. Objective: To …

Design, Develop And Manufacture A Low-Cost 32-Channel Biosignal Amplifier And D/A Converter Device For Multi- Electrode Neural Recording, Yen-Tze Liu

All ETDs from UAB

In the current market, there are many multichannel neural recording devices are available. However, they are either very expensive or physically big so that it cannot be used too close to the specimen because of the space limitations due to experimental setting such as Faraday cage, microscope, and other stimuli apparatus. In addition to that, the large electronic devices in the cell recording area are susceptible to create electrical noise, especially if they are not battery operated. This thesis work will try to deliver solutions following three main problems. The first problem we address is the device cost per recording …

Smile Outcome Comparison Of Orthodontic Cases Treated With Different Extraction Patterns, Gregory Long

All ETDs from UAB

Extraction of premolar teeth for orthodontic purposes is a common treatment approach. The effects of premolar extraction on the occlusion and the face have been studied extensively in the past. To date, however, the effects of premolar extractions on the smile have not been comprehensively quantified in the literature. The purpose of this study was to compare the smile outcome of patients treated with premolar extractions. Methods: This retrospective case-control study established 4 groups of 33 patients each for comparison. Three groups of patients with the same malocclusion were treated with different premolar extraction patterns. The remaining group of patients …

Insuring Graduation: An Analysis Of The Association Between Student Health Insurance And Graduation, John Robert Lovett

All ETDs from UAB

Most college students have access to basic health services through their campus’ college health program. Unfortunately, students who lack health insurance may be limited in their access to health services beyond the acute care provided, which may manifest in a myriad of adverse outcomes; ultimately resulting in withdrawal from college without graduating. Student health insurance plans (SHIPs) are high-quality, affordable insurance plans specially designed to meet this need. This study utilized survival analysis to examine the temporal nature of college graduation behavior, as it related to student health insurance status. The results of this study show no significant relationship between …

An Exploratory Study Of The Influence Of Perceived Organizational Support, Coworker Social Support, The Nursing Practice Environment, And Nurse Demographics On Burnout In Palliative Care Nurses, Marcia Ann Lowe

All ETDs from UAB

AN EXPLORATORY STUDY OF THE INFLUENCE OF PERCEIVED ORGANIZATIONAL SUPPORT, COWORKER SOCIAL SUPPORT, THE NURSING PRACTICE ENVIRONMENT, AND NURSE DEMOGRAPHICS ON BURNOUT IN PALLIATIVE CARE NURSES MARCIA A. LOWE SCHOOL OF NURSING ABSTRACT Burnout, a condition characterized by emotional exhaustion, depersonalization, and decreased personal accomplishment, has been studied in many disciplines in healthcare, including nursing, medicine, and social work. Working with palliative care patients and their families is innately challenging and may predispose nurses to burnout. The purpose of this study is to examine the influence of perceived organizational support (POS), coworker social support, the nursing practice environment, and nurse …