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Articles 9661 - 9690 of 10641
Full-Text Articles in Entire DC Network
Bio-Regenerative Life Support Systems Functional Stability And Limitations, A Theoretical Modeling Approach, Curt I. Holmer
Bio-Regenerative Life Support Systems Functional Stability And Limitations, A Theoretical Modeling Approach, Curt I. Holmer
Theses and Dissertations
Experiments with Ecological Closed Life Support Systems (ECLSS) for moderate sized crews have shown instability when supporting crews over long periods of time required for deep space travel. Tests such as Russia’s BIOS series, NASA’s Lunar-Mars Life Support Test Project (LMLSTP), ESA’s Micro-Ecological Life Support System Alternative (MELiSSA), and Japan’s Closed Ecology Experiment Facilities (CEEF) have shown that microalgae and higher plants combined with physical-chemical material converters can be a successful part of a Biological Life Support System or a Closed Ecological Life Support System. LMLSTP, MELiSSA, and CEBAS experiments as well as commercial Ecosphere products have proven stability at …
How Fishy Is Your Fish? Authentication, Provenance And Traceability In Fish And Seafood By Means Of Vibrational Spectroscopy, Aoife Power, Daniel Cozzolino
How Fishy Is Your Fish? Authentication, Provenance And Traceability In Fish And Seafood By Means Of Vibrational Spectroscopy, Aoife Power, Daniel Cozzolino
Articles
Food authenticity, traceability and provenance are emerging issues of major concern forconsumers, industries and regulatory bodies worldwide. In addition, both food safety and securityare an intrinsic component of food quality where the above issues are key in modern traceabilityand management systems. It has been reported that substitution of a high-quality species by lessexpensive ones might be a frequent practice in seafood products such as fish and shellfish. In thistype of products, the source (e.g., origin) and identification of the species are complex. Althoughdifferent countries have implemented strict regulations and labelling protocols, these issues still are ofconcern. This article briefly reviews …
The Effect Of Neonicotinoid Clothianidin On Ring-Necked Pheasant Survival And Reproduction, Michael Sundall
The Effect Of Neonicotinoid Clothianidin On Ring-Necked Pheasant Survival And Reproduction, Michael Sundall
Electronic Theses and Dissertations
Ring-necked pheasants (Phasianus colchicus) are economically important to the state of South Dakota bringing in over one hundred million dollars in revenue each season. The population is known to fluctuate temporally for many reasons, often weather related. Unfortunately, no research has been conducted involving ring-necked pheasants that evaluated the impact or interaction of neonicotinoids on the species. The objective of our study was to gain an understanding of how the neonicotinoid, Clothianidin, affects survival and breeding in pheasants. Our first experiment was to determine if there was a selection bias for seeds treated with neonicotinoids. In this experiment, eight ring-necked …
Biophysical And Socioeconomic Impacts Of Farmer Managed Natural Regeneration In Burkina Faso, Basnewende Brice Fulgence Zoungrana
Biophysical And Socioeconomic Impacts Of Farmer Managed Natural Regeneration In Burkina Faso, Basnewende Brice Fulgence Zoungrana
Electronic Theses and Dissertations
Human actions such as overgrazing, the development of cities at the expense of forests, high intensity and poor agricultural management, and so forth, reduce the resources available for future generations. Because Earth has limited resources, it is important to judiciously use and manage natural resources. Human actions towards nature are the focus of my research in Africa. Increased demands for grazing, agriculture, and ecosystem services led some farmers in developing countries to use unsustainable practices, which may lead to low incomes and poor food nutrition for households. Farmer managed natural regeneration (FMNR) may be a solution to these issues. FMNR …
The Role Of Food And Culinary Customs In The Homing Process For Syrian Migrants In California, Sally Baho
The Role Of Food And Culinary Customs In The Homing Process For Syrian Migrants In California, Sally Baho
University of the Pacific Theses and Dissertations
This interdisciplinary thesis explores the foodways of six Syrian migrant families, both immigrants and refugees, in California and the role that culinary customs play in their homing process. The homing process is the dynamic way in which people create home according to their life circumstances: food, eating, and culinary customs after migration in this case. Home is not only the place where people live, but also, where they come from and how they feel comfortable; home is both a physical space and an abstract concept. Home, and the various definitions of home, are mapped out in this project because understanding …
Insurance Status And Obesity As Predictors Of Cost In Trauma Care, Emily Homer
Insurance Status And Obesity As Predictors Of Cost In Trauma Care, Emily Homer
University of the Pacific Theses and Dissertations
Insurance is a vital factor in the billed cost to the patient, but to what degree does insurance explain the amount a patient is left to pay? Also, does obesity further influence patient’s billed cost? This thesis assesses the type of thoracic trauma patient, insurance status, and their billed cost. Database variables were analyzed in IBM SPSS 25. Table 1 characteristics were evaluated based on demographics and systematic hospital factors. Linear regressions used Private0_Government1 and BMI Obese n_y_ as independent variables while Total Patient Cost was the dependent variable. Private0_Government1 insurance explained .03% of Total Patient Charges. Private0_Government1 and BMI …
Safety And Effectiveness Of Stoss Therapy In Children With Vitamin D Deficiency, Paul Tannous
Safety And Effectiveness Of Stoss Therapy In Children With Vitamin D Deficiency, Paul Tannous
Theses
Objectives: Paediatric vitamin D (25-hydroxyvitamin D - 25OHD) deficiency can lead to nutritional rickets and extra-skeletal complications. Compliance with daily therapy can be difficult, making high dose, short-term vitamin D (stoss) therapy attractive to correct vitamin D deficiency. We compared the effectiveness and safety of standard versus stoss therapy in treating childhood 25OHD deficiency.
Study Design: Children aged 2 - 16 years with 25OHD <50nmol/L were randomized to either standard (5,000IU daily for 80 days) or stoss (100,000 IU weekly for 4 weeks) cholecalciferol. Participants underwent evaluation of effectiveness and safety. 25OHD, random spot calcium: creatinine ratio (Ca:Cr) and compliance were measured at 12 weeks.
Results: 151 children were enrolled in the study (68 standard and 83 stoss), median age 9 years (IQR: 6 - 12 years). Baseline 25OHD levels were 26 nmol/L (IQR: 19 - 35 nmol/L) and 32 nmol/L …
50nmol/l>A Western Australian Story: A Mixed Method Study Exploring Nutrition Knowledge, Food Intake, Influences On Food Choice, Body Image And Eating Attitudes Of University Students, Michelle Lambert
Theses
Emerging adults are fast gaining recognition as an important target group for health promotion as previous research indicates very few are meeting dietary guidelines, often consuming foods that have increased saturated fats, sugar and sodium. These eating patterns place this group at higher risk of developing chronic illnesses such as obesity, diabetes, cardiovascular disease and cancer. Understanding how and why these eating patterns develop is important to help establish healthy eating behaviours and greater compliance to Australian Dietary Guidelines – Recommended Daily Serves (ADG-RDS) for emerging adults. International research has focused on eating habits, weight gain patterns and possible influences …
Early Post-Operative Rises In Serum Metal Ion Levels In Total Hip Arthroplasty: A Prospective Cohort Study, Michael Le
Early Post-Operative Rises In Serum Metal Ion Levels In Total Hip Arthroplasty: A Prospective Cohort Study, Michael Le
Theses
Background: Serum Cobalt (Co) and Chromium (Cr) forms part of the diagnostic process for metallosis following Total Hip Arthroplasty (THA). While knowledge exists on longer term metal ion levels, expected early post-operative rises in serum Co and Cr in Metal-on-Polyethylene (MoP) THAs are currently unknown. This study aims to describe early rises in serum Co and Cr at 6 months post-operatively.
Methods: A prospective cohort study of 84 consecutive patients with an uncemented titanium stem from a single THA manufacturer was performed. Patients had either a metal (n=43) or ceramic (n=41) head articulating with a highly cross-linked polyethylene. Serum Co …
Characterization Of Proteins Found In Serum And Sputum Samples From Ventilator Associated Pneumonia Patients, Hima Priya Yenuga
Characterization Of Proteins Found In Serum And Sputum Samples From Ventilator Associated Pneumonia Patients, Hima Priya Yenuga
Browse all Theses and Dissertations
Ventilator associated pneumonia (VAP) is the most common nosocomial infection leading to increased mortality in ICU patients. The main goal of this project was to evaluate and analyze a number of different biomarkers of disease that may be involved in the transition to pneumonia in patients on ventilators. Patients in this study were in the ICU, required greater than or equal to 48 hours of mechanical ventilation, and had a Clinical Pulmonary Infection Score greater than or equal to 6. For this study we recruited 16 subjects who were on ventilator for more than 48 hours, obtained serum and sputum …
Food Accessibility Related To The Double Your Dollar Program, Julia Carlson, Heather Friedrich, Mechelle Bailey, Curt Rom
Food Accessibility Related To The Double Your Dollar Program, Julia Carlson, Heather Friedrich, Mechelle Bailey, Curt Rom
Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences
The Double Your Dollar (DYD) Program is a program that gives Supplemental Nutrition Assistance Program (SNAP) beneficiaries and Senior Farmers Market Nutrition Program (SFMNP) participants match dollars to spend at local farmers markets. The DYD’s goal is to incentivize healthy eating among individuals of low income and promote spending at farmers markets. Food insecurity affects over 60,000 individuals in Washington and Benton counties in Arkansas. The aim of this study was to assess how the DYD program impacted users’ food accessibility and how the program could be improved for the future. A survey was used to address basic demographics, type, …
Contribution Of Adaptive Immune Responses In Chronic Lung Diseases, Thi Kim Tran-Nguyen
Contribution Of Adaptive Immune Responses In Chronic Lung Diseases, Thi Kim Tran-Nguyen
All ETDs from UAB
Immune dysregulation is a hallmark of various chronic lung diseases such as Chronic Obstructive Pulmonary Diseases (COPD) and Idiopathic Pulmonary Fibrosis (IPF). Previous studies in our lab have shown evidences of autoimmunity such as increases in autoantibodies, abnormal T cell profile, immune complex deposition and the presence of ectopic lymphoid structures in the lung of these patients. This thesis consolidates two separate projects about various aberrant immune responses in these diseases. The first project identified Glucose-Regulated-Protein 78 (GRP78) as the common autoantigen in COPD and characterized how GRP78 autoantibodies may increase COPD mortality via its atherogenic effects. I demonstrated that …
Understanding Financial Hardship In Women With Breast Cancer, Courtney Williams
Understanding Financial Hardship In Women With Breast Cancer, Courtney Williams
All ETDs from UAB
Individuals with cancer are at risk of material, psychological, and behavioral financial hardship due to costly new treatments, increasing time on treatment, and longer survival. Breast cancer is an ideal environment to study financial hardship. Treatment options for metastatic breast cancer are heterogeneous due to differences in patient characteristics, disease biology, and because it has the largest number of treatment options of any metastatic cancer. In early stage breast cancer, treatment options include multimodality treatments, including surgery, radiation, and medical therapy (chemotherapy, hormone therapy, targeted therapy), with the choice for each modality being dependent on the other modality decisions. Despite …
Assessment Of Emergency Department High Utilizer Program In Public Health System Setting, Michael Malaise
Assessment Of Emergency Department High Utilizer Program In Public Health System Setting, Michael Malaise
All ETDs from UAB
is study examined whether a case management model designed to reduce emergency department utilization among patients described as super-utilizers in a public health system could also reduce the per patient cost of those super-utilizers. The setting for this study was a large public health system in a major metropolitan area. The study focused on a low-income, urban population. Given the program’s stated desire to improve the self-efficacy of patients over time so that they could take more ownership of their own health status, this study reviewed the program within the framework of self-efficacy theory. This research predicted that the case …
Molecular Regulation Of Glioblastoma Spatial Heterogeneity And Therapeutic Resistance, Soniya Bastola
Molecular Regulation Of Glioblastoma Spatial Heterogeneity And Therapeutic Resistance, Soniya Bastola
All ETDs from UAB
Glioblastoma multiforme (GBM) is a highly invasive, highly vascularized, and heterogeneous malignant tumor of the brain. Due to the highly infiltrative phenotype of GBM, surgery often leaves behind residual tumor cells. In many cases, recurrence occurs close to the surgical margin suggesting the role of these remaining cells in promoting tumor aggressiveness. Rapidly growing tumor creates subsequent hypoxic, and hypovascular core due to limited nutrients, whereas tumor cells in the leading edge have access to nutrients from vasculature enriched microenvironment. Studies have identified the cellular and molecular heterogeneity between the tumors in core and edge. Still, their mechanisms of intercellular …
Race, Type Ii Diabetes Mellitus And Vertebral Fragility Fractures: A Cross-Sectional Analysis From Nhanes, Yuchen At Xiao
Race, Type Ii Diabetes Mellitus And Vertebral Fragility Fractures: A Cross-Sectional Analysis From Nhanes, Yuchen At Xiao
All ETDs from UAB
IntroductionThis study examined the association between race and bone health, and if T2DM modifies this association in a diverse sample of adults. Methods We conducted a cross-sectional study using the 2013-2014 National Health and Nutrition Examine Survey (NHANES) data. Bone health outcomes included lumbar spine BMD (lowered BMD based on T-scores <-1), and vertebral deformities, assessed via vertebral fracture assessment (VFA), including presence, number of deformities, and severity ratio of deformities. T2DM status and other demographic, lifestyle, and health characteristics were self-reported via questionnaire data. To assess if T2DM modifies the association between race and bone health outcomes, we conducted stratified analyses using logistic regression for dichotomous outcomes, Poison regression for count outcomes, and linear regression for continuous outcomes. Results Non-Hispanic (NH) Blacks have significantly less odds of being lowered BMD and osteoporosis comparing to NH-Whites in the crude model and significantly less odds of having vertebral deformities comparing to NH-White in both crude and adjusted model for non-diabetic participants. Such differences are not observed in diabetic groups. Participants in Other race group have significantly more odds of being lowered BMD comparing to NH-Whites in the adjusted model for both diabetic and non-diabetic groups. And have significantly more odds of having vertebral deformities in the diabetic group, crude and adjusted, yet the differences are not significant in non-diabetic groups. Similar results were seen in the number of deformities and total bone loss ratio. The potential modification effect of T2DM was not significant in these models. Conclusions In our national evaluation, bone health differs not only by race and ethnic group but also by T2DM status. The protective vertebral fragility effects observed among NH-Blacks was no longer present among those with diabetes. Likewise, among participants in other racial and ethnic groups, T2DM seemed to magnify the association of worse vertebral fragility. Such trends indicate a potential modifying effect of participants’ T2DM status and should be noted clinically, yet more studies are required for more precise results.
A Modified Standard American Diet (Msad) Induces Physiological Parameters Associated The With Metabolic Syndrome In C57bl/6j Mice, Sophie Bru Chehade
A Modified Standard American Diet (Msad) Induces Physiological Parameters Associated The With Metabolic Syndrome In C57bl/6j Mice, Sophie Bru Chehade
All ETDs from UAB
Obesity manifests physiologically in multiple organ systems of the body, typically increasing the risk of developing cardiometabolic disorders. Researchers have questioned the causative role that western dietary patterns have on disease pathogenesis and have speculated that quality and quantity of dietary fats and/or carbohydrates have a predictive role in the development of these disorders. Standard reference diets such as the AIN-93 rodent diet have historically been used to promote optimal animal model health and reduce variation of results across experiments. These diets have been invaluable to murine research; however, their translational value in studying human nutrition-related pathologies is limited. Early …
Impact Of Diet And Meal Timing On Time-Of-Day Dependent Hippocampal Function, Jennifer Davis
Impact Of Diet And Meal Timing On Time-Of-Day Dependent Hippocampal Function, Jennifer Davis
All ETDs from UAB
Circadian rhythms are biological processes that cycle every ~24 hours and have allowed life to adapt for optimal function across the day. These rhythms are present in all tissues in the body and are coordinated to the light/dark cycle by the suprachiasmatic nucleus (SCN) in the hypothalamus. Along with active-rest cycles, cognitive performance fluctuates across the course of the day, peaking during the active phase. In addition to the light cycle, food and meal timing can provide signaling cues to extra-SCN tissues. Food access only during the inactive phase results in weight gain and memory impairment. High fat diet protocols …
Calibration Of Periodontal Diagnosis Among Participants Of Various Dental Education Levels, Shadi Alkhoury
Calibration Of Periodontal Diagnosis Among Participants Of Various Dental Education Levels, Shadi Alkhoury
All ETDs from UAB
ABSTRACT: The purpose of this project is to assess the level of calibration among dental students of two different education levels and postgraduate students of two different dental specialties during diagnosis and treatment planning of clinical cases with various levels of periodontal involvement, using the 2018 Classification of Periodontal and Peri-implant Diseases and Conditions. Fifty-seven second year dental students (D2), 45 fourth year dental students (D4), 17 orthodontic postgraduate students (OS) and 12 postgraduate periodontology (PS) students were presented with an anonymous survey of 10 different cases, each with 5 choices of diagnosis and 7 therapeutic approaches. Consensus diagnosis was …
Early Childhood Quality Of Education And Late-Life Cognitive Function In A Population-Based Sample From Puerto Rico, Cheyanne Celine Barba
Early Childhood Quality Of Education And Late-Life Cognitive Function In A Population-Based Sample From Puerto Rico, Cheyanne Celine Barba
All ETDs from UAB
In general, greater years of education is associated with reduced risk of cognitive impairment in older adulthood, but the strength of this association has been found to differ by study population. Additionally, quality of education is understudied, despite evidence that quality of education and, in turn, literacy, may be additional indicators of cognitive reserve. This thesis examined years of education, literacy, and childhood quality of education indicators in relation to late-life cognitive outcomes in an older Puerto Rican population. We hypothesized that greater years of education, literacy, and quality of childhood education would be positively associated with each other, as …
Self-Awareness Of Functional Deficits In Older Adults With Mild Cognitive Impairment, Kayla Ann Steward
Self-Awareness Of Functional Deficits In Older Adults With Mild Cognitive Impairment, Kayla Ann Steward
All ETDs from UAB
Performance of instrumental activities of daily living (IADLs) can become compromised in older adults with mild cognitive impairment (MCI). Poor self-awareness of deficits, also known as anosognosia, occurs in a substantial minority of those with MCI and varies in extent depending on the domain examined. This dissertation attempts to explain the inter- and intra-patient variability in anosognosia by examining (1) differences in objective IADL performance and self-awareness of functional difficulties between those with amnestic single- (-ASD) and multi-domain (-AMD) MCI, and by examining (2) the neuropsychological and (3) neuroanatomical correlates of anosognosia for IADLs in older adults across a broad …
O'Kei: An American Novel, Boris Pilnyak, Ronald D. Leblanc (Translator)
O'Kei: An American Novel, Boris Pilnyak, Ronald D. Leblanc (Translator)
Faculty Publications
On January 4, 1931, Boris Pilnyak (1894-1938) wrote a letter to Joseph Stalin, pleading with the Soviet leader to grant him permission to travel to the United States in order to conduct research for an ambitious book project he was undertaking that would compare communist Russia favorably to capitalist America. Pilnyak’s request received official approval, and a few months later the writer set off for the U.S., arriving in New York by steamer on March 12, 1931, and remaining in the country until August 3, 1931. During his nearly five-month stay in America, Pilnyak became acquainted with a number of …
Psychometric Evaluation Of A Perceived Barriers To Medication Adherence Instrument And Association Between Perceived Barriers And Patient Characteristics, Lynn Andreae
All ETDs from UAB
Medication adherence is an important component of diabetes management, yet nonadherence is common and has substantial patient and economic costs. In order to achieve meaningful improvements in medication adherence, clinicians and researchers need good ways of both identifying those at risk of nonadherence and ascertaining the specific reasons driving nonadherence in those patients. Current options for self-reported medication adherence are limited in their vulnerability to response bias, which may lead to overestimation of adherence. A measure that assesses perceived barriers to medication adherence may be a useful alternative, as it may identify patients at risk of nonadherence while reducing socially …
Spectrum 2020, Saint Mary's College Of California
Spectrum 2020, Saint Mary's College Of California
The Undergraduate Spectrum
No abstract provided.
Individual And Community Social Determinants Of Health Associated With Diabetes Management In A Mexican American Population, Kehe Zhang, Belinda Reininger, Miryoung Lee, Qian Xiao, Cici Bauer
Individual And Community Social Determinants Of Health Associated With Diabetes Management In A Mexican American Population, Kehe Zhang, Belinda Reininger, Miryoung Lee, Qian Xiao, Cici Bauer
Faculty, Staff and Student Publications
Background: Diabetes is a major health burden in Mexican American populations, especially among those in the Lower Rio Grande Valley (LRGV) in the border region of Texas. Understanding the roles that social determinants of health (SDOH) play in diabetes management programs, both at the individual and community level, may inform future intervention strategies.
Methods: This study performed a secondary data analysis on 1,568 individuals who participated in Salud y Vida (SyV), a local diabetes and chronic disease management program, between October 2013 and September 2018 recruited from a local clinic. The primary outcome was the reduction of hemoglobin A1C (HbA1C) …
Reprograming Neuronal Cells By Overexpression Of Fibroblast-Specific Transcription Factors, Abdulmohsen Alanazi
Reprograming Neuronal Cells By Overexpression Of Fibroblast-Specific Transcription Factors, Abdulmohsen Alanazi
Masters Theses
In mammals, a complex system of regulatory signals distinguishes tissues, structures and functions. Combinations of transcription factors and co-factors regulate activation and repression of genes that result in cellular differentiation. Whole genome arrays allow the monitoring of genomic expression in specific tissues. Fibroblast microarray studies have shown candidate genes that may be involved in fibroblast identification, including genes that express transcription factors Prrx1, Snai2 and Twist1. A previous study showed that the Prrx1 and Snai2 could reactivate a fibroblast phenotype in hybrid cells that had lost fibroblast identity. Furthermore, overexpression of these factors in liver-derived cells strongly repressed liver gene …
Leadership Development In East Africa: A Case Study Of A Multi-Year College Student Leadership Program, Gregory Armen Muger
Leadership Development In East Africa: A Case Study Of A Multi-Year College Student Leadership Program, Gregory Armen Muger
Theses and Dissertations
Effectual and ethical leadership is a top need throughout all sectors in Sub-Saharan Africa (Adadevoh, 2007; Ncube, 2010). Unfortunately, there is currently very scant literature on Sub-Saharan African leadership theory or programming (Bolden & Kirk, 2009). A large Christian nonprofit organization operated a multi-year servant leadership-based Christian leadership program for thousands of college students throughout sites in East Africa called the Leadership Development Program (LDP). The LDP endeavored to groom local, ethical, and capable leaders. Therefore, studying the LDP model and its impacts could add significant value to Sub-Saharan African leadership practitioners as well as add to the limited body …
Childhood And Adolescent Obesity Prevention In Twin Falls, Idaho, Allison Welch
Childhood And Adolescent Obesity Prevention In Twin Falls, Idaho, Allison Welch
Selected Social Change Portfolios in Prevention, Intervention, and Consultation
Obesity, a condition that negatively affects an individual’s physical and mental health, is a growing problem in Twin Falls, Idaho. Like the United States as a whole, Twin Falls County is experiencing an obesity crisis. According to the Centers for Disease Control and Prevention ([CDC], n.d), the national obesity rate has increased by 12% from 2000 to 2018. The Twin Falls County obesity rate has increased from 21% in 2011 to 33% in 2020 (County Health Rankings & Roadmaps, 2018). While it took the nation 18 years to increase the obesity rate by 12% (CDC, n.d.), it only took Twin …
Promoting Healthy Strategies To Reduce Obesity, Jarae Swanstrom
Promoting Healthy Strategies To Reduce Obesity, Jarae Swanstrom
Selected Social Change Portfolios in Prevention, Intervention, and Consultation
Sandpoint is a rural community in Northern Idaho with a population of 9,000 in the city limits and 46,000 within the county. Sandpoint is the largest town and the primary source for all services within Bonner County. There is an abundance of outdoor activities to enjoy with the largest and deepest lake in Idaho and many mountains nearby. Even though Sandpoint residents have many options to stay physically active and maintain a healthy weight, a continual rise in obesity within the community and across America has become a trend (County Health Rankings & Roadmaps, 2018). Likewise, the lack of affordable …
Substance Use In Pender County, North Carolina., Khristine Winstead
Substance Use In Pender County, North Carolina., Khristine Winstead
Selected Social Change Portfolios in Prevention, Intervention, and Consultation
This portfolio explores substance use in Pender County, NC. Recent data from the community health opinion survey indicates that substance use in Pender County is the number one community issue (Pender County Health Department, 2018). From 2012 through 2016, the number of Pender County resident babies hospitalized with drug withdrawal syndrome per 1,000 was 20. To contrast, as a whole, the state of North Carolina recorded 9 per 1,000 (Pender County Health Department, 2018). To date, the local management entity (LME) in Pender County responsible for managing state and federally funded services, including substance use disorders, is Trillium Health Resources. …