Digital Commons Network^™

"Organizational Characteristics And Market Factors Associated With The Adoption Of Hospital At Home", Vincent Turner

All ETDs from UAB

ORGANIZATIONAL CHARACTERISTICS AND MARKET FACTORS ASSOCIATED WITH THE ADOPTION OF HOSPITAL AT HOME VINCENT TURNER, JR. HEALHTCARE LEADERSHIP ABSTRACT The healthcare environment has continued to be reshaped and forced to evolve over the last several decades and even more so in recent years. This evolution and reshaping have been forced by both internal and external factors withing the healthcare landscape. This has tasked hospital leaders with exploring new ways of delivering care. The COVID-19 pandemic was an external circumstance the forced hospital leaders to look at alternate ways of providing care, more specifically in the home setting. Hospitals were introduced …

Understanding Clinical Tool Adoption In Primary Care: A Case Study Of The Cmds Care Pathway, Khushbu Khatri Park

All ETDs from UAB

The rising prevalence of obesity, diabetes, and cardiovascular disease (CVD) places increasing strain on healthcare systems and primary care providers (PCPs). In response, the University of Alabama at Birmingham (UAB) adapted the Cardiometabolic Disease Staging System (CMDS), a validated clinical decision support tool, designed to stratify patient risk and guide evidence-based treatment. Embedded within the electronic health record (EHR) as a Care Pathway, the CMDS was designed for real-time use during primary care visits. This dissertation examines utilization of the CMDS in a two-phase case study, guided by the Adult Learning Theory, Group Dynamics Theory, Force Field Theory and Change …

The Hepatic Glucagon Receptor As A Novel Regulator Of Lifespan, Alexander Tate Lasher

All ETDs from UAB

In developed nations the average lifespan has nearly doubled over the last 200 years, and the proportion of humans living into old age is ever increasing. While this is certainly a testament to the effectiveness of modern medicine and infrastructure, it presents a unique challenge to public health. Gains to health have not necessarily kept pace with the gains in lifespan, and the expanding aged population positions age-associated diseases to reach unprecedented prevalence. In light of this challenge, a mechanistic understanding of the aging process is necessary to identify factors that control longevity and to ultimately develop strategies for healthy …

Bridging The Gap: Exploring The Facilitators And Barriers In The Self-Management Of Diabetes And Pain In Rural Southern Communities, Kennedy Nicole Butler

All ETDs from UAB

Southern rural communities experience a higher prevalence of Type 2 diabetes (T2D) and associated comorbidities, which increases rates of premature mortality due to socio-environmental factors, pre-existing health conditions, and economic burden in comparison to their urban counterparts. Fifty percent of individuals with T2D experience pain or chronic pain (CP); however, individuals in rural communities disproportionately experience symptoms of CP. CP is a physically debilitating condition that can inhibit mobility and reduce quality of life. T2D and the co-occurrence of CP can limit an individual's ability to engage in self-managing behaviors. While diabetes self-management education and support (DSMES) programs, along with …

Investigating The Role Of Fibroblast Growth Factor Signaling In The Cystic Fibrosis Airways, Meghan June Hirsch

All ETDs from UAB

Cystic fibrosis (CF) is an autosomal recessive disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene which results in complications in organs such as the lung, pancreas, liver, and intestines. In the lung, defective CFTR results in thick, sticky mucus that causes susceptibility to colonization of opportunistic pathogens such as Pseudomonas aeruginosa (PA), progressive lung damage, and ultimately a decrease in life expectancy in affected individuals depending on severity of disease. Additionally, one of the characteristics of this disease, with and without PA infection, is chronic inflammation. Chronic inflammation has also been associated with accelerated aging …

Mcl1 And Hexokinase 2 Form A Glucose Metabolic Regulatory Axis, Robert Lee

All ETDs from UAB

Hexokinase 2 (HK2) initiates glucose metabolism by catalyzing the conversion of glucose to glucose-6-phosphate providing the starting substrate for a vast array of metabolic pathways such as glycolysis, pentose phosphate pathway (PPP), amino acid biosynthesis and others. While HK2’s metabolic role in normal physiologic function (such as in cardiomyocytes) and cancers (through driving the Warburg Effect) are well established, there is emerging evidence that supports HK2 is also a critical mediator of protein-protein interactions that regulate cell survival. Through comprehensive review, we explore how HK2 contributes to cell survival through metabolic and protein scaffolding roles. We also investigate a novel …

Compartmentalized Antigen Presentation By Intestinal Epithelial Cells Directs Cd4 T Cell Fate, Christopher Garrett Wilson

All ETDs from UAB

The intestinal epithelium maintains a complex relationship with both commensal microbiota and enteric pathogens while orchestrating local immune responses. Although intestinal epithelial cells (IECs) can express MHC class II molecules during inflammation, their functional contribution to pathogen-specific adaptive immunity and immunological memory remains poorly defined. This dissertation investigates the hypothesis that IECs actively shape CD4+ T cell responses through antigen presentation, using Citrobacter rodentium infection as a physiologically relevant model of human attaching and effacing bacterial pathogens. The C. rodentium model offers unique advantages for dissecting epithelial-immune interactions: it naturally infects mice through oral inoculation, exhibits precise anatomical tropism for …

Amygdala Npy+ Interneurons Are Activated By Aversive Stim-Uli, Patric Perez

All ETDs from UAB

Neuropeptide Y (NPY) serves as a critical endogenous anxiolytic and stress-buffering molecule, yet the temporal and spatial dynamics of NPY+ cells during fear learning re-main unknown. Temporal dynamics can be measured with in vivo calcium imaging tech-niques, which enable real-time monitoring of cell-type-specific neural activity in freely behaving animals. Snapshots of neuronal activation can be measured using c-Fos im-munohistochemistry, thereby providing excellent spatial resolution. Here, I employ cut-ting-edge approaches to characterize the temporal and spatial activation patterns of NPY+ cells in amygdala, a key fear-regulating brain region negatively impacted by aversive events. I first used in vivo fiber photometry, together …

Bridging Fact And Fiction: Lawrence Alma-Tadema’S And Georg Ebers’ Visions Of Ancient Egypt, Elizabeth Casement

All ETDs from UAB

Existing research on the methodology behind the production of ancient Egyptian-themed paintings of Lawrence Alma-Tadema (1836-1912) has centered on his use of an extensive cache of reference materials. This thesis suggests that Alma-Tadema’s sources of historical information and creative influence far exceeded his private reference library, also hinging on his vast personal network and specifically examining the collaborative friendship he maintained with German author and professor of Egyptian studies Georg Ebers (1837-1898). A thorough reading of letters from Alma-Tadema to Ebers elucidates the impact of the German author on the artist’s understanding of Egypt from the Pharaonic to the Roman …

Proteasome Augmentation Is Protective Against Alzheimer’S Disease And Agerelated Cognitive Decline, Kanisa Davidson

All ETDs from UAB

Proteostasis is essential for the degradation of oxidized, misfolded proteins and proper function of neuronal plasticity. Proteasome inhibition has been shown to exacerbate cognitive and behavioral deficits in aging and Alzheimer’s Disease (AD) models. Proteasomal activity is decreased across human and animal models of AD. We hypothesize that aging and AD markers, β-amyloid and/or hyperphosphorylated tau, impair proteasome function, thereby preventing the proteasome’s capacity to degrade critical synaptic proteins essential for memory formation. We investigated the role of pharmacological and genetic augmentation on proteasomal function, to rescue aging and AD-like cognitive deficits in cell culture, Drosophila, and mice. We demonstrate …

Promoting Mental Health And Social-Emotional Development In Underserved Families, Brianna Paquette

All ETDs from UAB

The overarching goal of this dissertation was to investigate interventions that aimed to support mental health and child development in underserved families. Individuals from low-income households often experience mental health difficulties, such as higher rates of caregiver depression. Additionally, children from disadvantaged backgrounds are more likely to face difficulties with social and emotional development. This dissertation is comprised of three papers exploring interventions to facilitate child development and well-being in low-income families. The first paper is a systematic review and meta-analysis on home visiting interventions aimed at supporting the social-emotional development of children from birth to five years of age. …

Wellness Perspectives Of Early Career Teachers: An Exploratory Study Of School Culture And Environment, Amy Day Carr

All ETDs from UAB

Purpose: The purpose of this grounded theory dissertation was to explore Alabama early career teachers’ perceptions of personal wellness, the wellness culture and environment of their school system, and the impact of the culture on teacher wellness and job satisfaction. Early career teachers face unique challenges that contribute to high turnover rates, yet their wellness has not been systematically studied. This study sought to answer three primary research questions with sub-questions. Teachers were asked to describe their personal wellness, the wellness culture at their schools, and the effect of the wellness culture and environment of the school on teachers in …

Measuring Emotional Well-Being Across Neurodevelopmental Disorders, Alecia Mercier

All ETDs from UAB

Emotional well-being has emerged as a crucial determinant of both physical and mental health, with implications for public health initiatives aimed at improving quality of life and reducing mortality. However, a clear and consistent understanding of emotional well-being, its components, and optimal measurement strategies remains lacking, especially for individuals with neurodevelopmental disorders. This dissertation investigated how emotional well-being is conceptualized and measured in individuals with neurodevelopmental disorders. Paper one was a scoping review that identified 20 emotional well-being measures developed or adapted for individuals with intellectual and developmental disabilities. Findings demonstrated that many existing measures do not include emotional well-being …

Those Who Strayed: Quaker Abolitionist John Greenleaf Whittier, And The Grimké Sisters Who Broke From The Society Of Friends To Actively Oppose Slavery In The Antebellum Era, David Mark Ledlow

All ETDs from UAB

The adoption of quietist theology by the Quaker community in the early nineteenth century created a divide between Quakers and their abolitionist movement due to the differing methods to achieve an end to slavery. Quaker society began to adopt a stance that avoided all controversies and employed conservative actions to combat slavery while abolitionist began to speak out more against the evils of slavery regardless of any controversy. This divided left Quaker abolitionist like John Greenleaf Whittier and the Grimké sisters with the choice to distance themselves from the Society of Friends or the abolitionist movement. Whittier and the Grimké …

Reducing The Risk Of Phishing Attacks Through Providing Consistent Training Via The Kaizen Education Platform, Dalton E. Pena

All ETDs from UAB

Introduction: Many healthcare organizations have experienced cybersecurity related phishing email attacks, costing these organizations many thousands to many millions of dollars to release ransomed data to maintain patient care delivery and operations. Use of technology alone has proven to be insufficient, as most occurrences of data breaches are related to human behaviors. Background: Cybersecurity is a threat increasingly common to healthcare organizations, and it is gaining in both sophistication and complexity, aided by artificial intelligence. Healthcare organizations have adopted new technologies and increased the prevalence of cybersecurity training to develop a healthy cyber culture and construct a human firewall against …

Psychedelics And Psychosis: An Interdisciplinary Re-Examination, Haley Maria Dourron

All ETDs from UAB

Psychedelics have long been described as potential drug models of psychosis. There is also concern that psychedelics might worsen psychotic symptoms in individuals with a history of psychotic disorders. This dissertation examines the overlap between psychedelic-induced states and non-affective psychotic disorders (NAPD) from both subjective and neurological perspectives, as well as the perceived impact of psychedelic use in people with a history of NAPD. Nineteen people with a history of NAPD who had used psychedelics were interviewed about their experiences. Participants generally described psychedelic and psychotic experiences as distinct, though both affected similar experiential domains, such as sensory alterations. Altered …

Influence Of Transportation Access And Geographic Distance On Retention And Completion In Substance Use Treatment: A Retrospective Study Of In-Person And Telehealth Modalities, Yasemin Tanik Morgan

All ETDs from UAB

Substance use disorder (SUD) remains a public health concern in the United States. Low-income and underserved populations continue to face barriers to accessing effective treatment. The rapid expansion of telehealth has been proposed as a solution to barriers such as geographic distance and transportation. However, it is unclear whether telehealth effectively addresses these barriers or how access-related factors influence treatment outcomes across care modalities. This retrospective cohort study, guided by the Social Determinants of Health (SDOH) framework, evaluated the impact of treatment modality, transportation access, and geographic distance on retention and completion in a publicly funded Intensive Outpatient Program (IOP) …

Policy Surveillance Of Decommissioning And Decontamination Regulations, Joshua Gary Collins

All ETDs from UAB

Policy surveillance is an analytical collection and study of regulatory action within the public health field. Due to the vastness of the United States regulatory system, large amounts of time and effort are needed for policy surveillance to be accomplished. When considering nuclear decommissioning policies, all state and local regulations should start with the Nuclear Regulatory Commission’s (NRC) requirements, however states have the freedom to increase stringency. Policy surveillance allows for both a convenient and approachable way to reference important regulations in a timely manner while also functioning as a method to identify and manage any inconsistencies found between the …

A Concurrent Mixed Methods Formative Process Evaluation Of A Telehealth Mental Health Awareness Program For People With Mobility Limitations, Sangeetha Mohanraj

All ETDs from UAB

People with mobility limitations face higher levels of mental health challenges and often face barriers to accessing mental health resources to overcome them. Raising mental health awareness and providing accessible resources are essential for improving the quality of life in this population. The NCHPAD’s (National Center on Health, Physical Activity, and Disability) GROWTH (Growing Resilience Out of Wellness and Thoughtful Habits) program is a telehealth mental health wellness program developed for individuals with mobility limitations. The primary objective of this dissertation is to conduct an process evaluation of the GROWTH pilot program using a mixed methods approach to assess its …

Attitudes Of Optometrists Towards Referring Patients For Nutrition And Lifestyle Changes To Treat Diabetic Retinopathy And Age-Related Macular Degeneration, Samantha Chapman

All ETDs from UAB

Some ocular diseases, including diabetic retinopathy and age-related macular degeneration, have direct links to systemic diseases or the condition of the body as a whole. Specific diet and lifestyle changes have been studied in relation to these two diseases and, while it is not within the scope of optometry to prescribe these changes for patients, an optometrist may refer to a variety of specialists so that patients can receive the most holistic care available. The primary goal of this study is to assess the attitudes of currently practicing United States optometrists towards referring to nutrition and lifestyle professionals and their …

Core Body Temperature (Cbt) Monitoring Among Groundskeepers Under Heat Stress, Lara Anne Parker

All ETDs from UAB

Heat is the leading cause of death for outdoor workers. In Alabama, there are an estimated 11,160 - 21,460 workers employed in the landscaping and groundskeeping industry, which are vulnerable to heat-related illnesses (HRI). In this study, core body temperature (CBT) and wet-bulb globe temperature (WBGT) index were examined as potential indicators of heat stress. A SlateSafety (SS) Band V2 wearable CBT device and a WBGT monitor were used to collect CBT and WBGT values, respectively. Sampling for the main two measurements was performed over five days for two participants. An additional CBT device option, the e-Celsius performance ingestible pill, …

High Pressure And High Temperature Exploration Of Phase Transformations In Eutectic High Entropy Alloys, Andrew Dobbs Pope

All ETDs from UAB

The overall goal of this research is to understand the mechanism of phase transformations in far-from-equilibrium micro/nano-structures produced by additive manufacturing of compositionally complex alloys. The eutectic high entropy alloys based on nickel were selected for this study because of their high tensile strength as well as high ductility. This study examines the high-pressure behavior and phase transformations of laser powder-bed fusion manufactured eutectic high-entropy alloys, specifically AlCoCrFeNi2.1 and Al18Co20Cr10Fe10Ni40W2. Both alloys exhibit a nano-lamellar structure composed of body-centered cubic and face-centered cubic phases. The BCC to FCC phase transformation under high pressures was observed below 21 Giga-Pascals (GPa) in …

Evaluating Relative Value Units And Its Alternatives Inradiology, Alfred Matthew Dewey

All ETDs from UAB

ABSTRACT Radiologist productivity in the United States is traditionally measured by thework Relative Value Unit (wRVU). However, wRVUs fail to capture several criticalaspects of radiologic work, including study complexity, patient characteristics, andfacility factors. This study evaluated the statistical significance of wRVUs as a measureof productivity and proposes an alternative model grounded in ascribable time—themeasurable duration a radiologist takes to interpret and report a study.A comprehensive literature review highlighted the inadequacy of wRVUs inaccounting for technological advances, case complexity, and workflow differences.Applying contingency theory as the guiding framework, this study posited that radiologyproductivity must be tailored to institutional and contextual variability. …

The Impact Of Nursing Home Ownership On The Election Of Advance Care Directives, Natasha Elie

All ETDs from UAB

Approximately 1.3 million people reside in nursing homes/facilities. Annually, this population represents 25% of mortalities in the United States. The enactment of the Patient Self Determination Act (PSDA) required nursing homes/facilities to educate patients, staff, and the community on the right to advance care directives. This study aimed to evaluate the impact of nursing home ownership on the election of ACDs and end-of-life care services by examining how nursing homes ownership in New York, California, and Ohio compared regarding residents' election of ACD and whether there was a variation in the these states. This paper contributes to the literature by …

An Analysis Of Gamma-Aminobutyric Acid Levels With Structural And Functional Connectivity In Antipsychotic Medication-Naïve First Episode Psychosis Patients, Genelle Dano Samson

All ETDs from UAB

Schizophrenia is a complex psychiatric disorder characterized by hallucinations, delusions, disorganized thinking, and abnormalities in emotional expression, social interaction, and motivation. Cognitive deficits and alterations in perception are core features of psychosis spectrum disorders, though the neurobiological bases of these impairments are not thoroughly understood. Examination of the structures responsible for cognition, along with how their connectivity and neurochemistry are altered in psychosis, is crucial to understanding and treating schizophrenia. Gamma-aminobutyric acid (GABA) is the primary inhibitory neurotransmitter in the central nervous system and plays a crucial role in the regulation of neuronal activity. Evidence from animal models and postmortem …

The Effectiveness Of The Project-Based Learning (Pjbl) Model Based On Tiktok Videos In Improving Elementary School Students’ Understanding Of Cultural Diversity Concepts, Putri Fajriani, Encep Supriatna, Mubarok Somantri, Resti Hidayat

Jurnal Pendidikan: Teori, Penelitian, dan Pengembangan

In the 21st‐century digital era, education faces challenges in integrating innovative technologies with relevant curricula, particularly in elementary‐level cultural diversity learning that still relies on traditional methods and lacks engaging media. This study analyzes the effectiveness of integrating Project‐Based Learning (PjBL) with TikTok videos to enhance primary students’ understanding of cultural diversity through a comprehensive systematic literature review. Keyword searches in Google Scholar, Scopus, the Indonesian Publication Index, and university journal portals yielded 48 articles, of which 25 met inclusion criteria—15 quasi‐experimental studies, 6 descriptive studies, and 4 meta‐analyses (14 national, 11 international). Findings reveal that optimal PjBL implementation increases …

Editorial: A Step-By-Step Statistical Decision Framework For A Gender-Inclusive Approach In Sport And Exercise Science Research, James W. Navalta, Dustin W. Davis, Jafra D. Thomas, Whitley J. Stone

International Journal of Exercise Science

International Journal of Exercise Science 18(1): 1010-1029, 2025. The conflation of sex and gender in sport and exercise science research has led to gaps in representation and understanding of gender-inclusive outcomes. This invited editorial presents a framework to guide researchers in conducting statistical analyses that account for multiple gender identities beyond the traditional binary classification. The invited editorial guides deliberation on whether to test for sex or gender differences in sport or exercise science research. It prompts investigators to answer the question, “Is there a valid, literature-supported rationale for investigating sex or gender differences?” If “yes”, we propose approaches that …

Global Nursing Education Through Simulation Technology: Enhancing Mass Casualty Training, Matt Anderson, Adrianna Lorraine Watson, Jeanette Drake, Sonrdra Heaston, Chynna Hartle, Lauralee Preece

International Nursing Research Congress (INRC)

Background: Nursing education is a global requirement, with many institutions worldwide struggling to find adequate space, time, personnel, and finances to invest in high-quality educational modalities for disaster preparedness and interdisciplinary communication or teamwork. This modality was designed with the global implications of a scalable approach to high-quality education while anticipating financial and logistical challenges.

Purpose: to assess the self-efficacy and experiences of undergraduate student nurses and EMTs participating in a mass casualty incident simulation (MCIS).

Methods: This study was designed as a mixed-methods study in which proportional odds logistic regression was paired with thematic analysis to present a complete …

Interdisciplinary Simulation With Psychiatric Nurse Practitioner And Midwifery Students, Marissa Decesaris Siegel, Abigail Howe-Heyman, Joseph Schatz

International Nursing Research Congress (INRC)

Background: Mental health is the leading cause of pregnancy-related mortality in the United States.¹ Both psychiatric and midwifery providers often lack confidence in managing mental health disorders in perinatal patients and may also lack experience in interprofessional collaboration, a key domain of the American Association of Colleges of Nursing’s Essentials.² We are not aware of any existing programs that use interprofessional education to address perinatal mental health.

Purpose: The purpose of this project was to assess the feasibility of a post-partum depression simulation with psychiatric/mental health nurse practitioner (PMHNP), women's health/gender-related health nurse practitioner (WHGRNP), and nurse- midwifery …

Trust, Blame, And The Words Nurses Use, Jane K. Dickinson, Susan J. Guzman, Jennalee Wooldridge

International Nursing Research Congress (INRC)

The purpose of this study was to quantify emotional responses, including trust and blame, of people with diabetes, when exposed to problem words.
People with diabetes experience words that are judgmental and based on blame.¹ Language guidance papers have been developed in multiple countries, because negative messages can be harmful to people with diabetes.² A recent integrative review synthesized studies on communication and diabetes outcomes and concluded that negative messages can lead to diabetes distress, decreased health behaviors, and poor health outcomes. On the other hand, positive or supportive messages can lead to positive health behaviors.³
Trust …