Digital Commons Network^™

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 …

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, …

Racial/Ethnic Heterogeneity In Women’S Aging Experiences Over Time: A Latent Transition Analysis, Joshua Christian Julian Lewis

All ETDs from UAB

U.S. population aging and unprecedented racial/ethnic diversity will affect the types of social and healthcare services older adults need. These projections have renewed attention to healthy aging, which refers to the physiological/functional, psychological, and social capacity to maintain well-being. Extant research finds that most are aging unwell and through binary and biomedical operationalizations—which do not account for patterns of chronic conditions, disability, intersecting race / ethnic and gender inequality, socioculturally developed resources, and social relations—reifies the exceptions, typically men and non-Hispanic Whites, as the “aging well” benchmark. Integrating theoretical considerations of the life course, cumulative inequality, stress process, and limitations …

Voices From Two Secondary Newcomer Programs In Alabama: A Multiple Case Study, Carl Anthony Floyd Jr

All ETDs from UAB

This multiple case study investigates the design, implementation, and impact of two secondary newcomer programs in Alabama, with a focus on Students with Limited or Interrupted Formal Education (SLIFE) and non-SLIFE English Learner (EL) newcomers. Grounded in Esteban-Guitart et al.’s (2023) framework of community funds of knowledge and identity, the study explores how these programs function as community educational ecosystems. Data were collected through interviews, observations, and document reviews across two school districts and analyzed using ethnographic and thematic methods. Findings reveal that when newcomer programs are intentionally designed to leverage community assets and cultural identities, they provide meaningful academic, …

Parenting And Parental Well-Being As Risk And Resilience Factors For Mental Well-Being In Adolescents With And Without Neurodevelopmental Disorders, Wanqin Yu

All ETDs from UAB

Parenting practices and caregiver well-being are widely recognized as key determinants of adolescent mental health. However, few studies have examined how these factors operate in the context of neurodevelopmental disorders (NDDs), particularly through a risk and resilience framework. This study investigated how positive and negative parenting practices, caregiver well-being, and parenting stress relate to adolescents’ emotional well-being and internalizing problems. It also explored whether these variables differed between adolescents with and without NDDs. Participants included 105 adolescents aged 11–14 years (61.9% female; 52.4% diagnosed with an NDD) and their caregivers, drawn from a larger study on adolescent socio-emotional competencies. Caregivers …

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 …

Calibrating A Holling-Tanner Model With Applications To S&P500 Forecasting, Jonathon Knowles

All ETDs from UAB

The primary goal of this thesis is to improve upon existing dynamical system models in economics. Existing models utilizing Lotka-Volterra dynamics display a tendency to suffer from unrealistic forecasts dominated by exponential growth and decay. Additionally, current inverse methods are only applicable in differential equation systems with linear coefficients. In this body of work, we propose novel methods for handling these challenges.

The Longitudinal Associations Between The Longitudinal Associations Between Parent Involvement And Academic Achievement In Elementary School Involvement And Academic Achievement In Elementary School, Makayla Elizabeth Warnecke

All ETDs from UAB

Parent involvement has been positively linked to children’s academic outcomes (e.g., Chavkin, 1993; Eccles & Harold, 1993; Epstein, 1989, 1994; Hess & Holloway, 1984; Hobbs et al, 1984; U.S Department of Education, 1994). These outcomes include higher achievement test scores (Keith et al., 1986), better grades (NCES, 1985), and increased rates of secondary school completion (Chavkin & Williams, 1993; Delgado-Gaitan, 1988, 1992; Epstein, 1986, 1995; Angiano, 2004). However, gaps remain in the current state of research when investigating longterm implications. In a recent meta-analysis, researchers stated the lack of analyses using a longitudinal cross-lagged design as a future direction (Barger …

Adult Role Transitions And Substance Use In Black And White Young Adults, Kristina Brooke Mcmahan

All ETDs from UAB

ADULT ROLE TRANSITIONS AND SUBSTANCE USE IN BLACK AND WHITE YOUNG ADULTS ABSTRACT Substance use, including alcohol, tobacco, and cannabis, often begins during adolescence and young adulthood, which is a developmental period marked by major life transitions such as graduating college, entering full-time employment, and parenthood. Adult role transition patterns may influence substance use and mental health outcomes; however, limited research has examined these associations in racially and socioeconomically diverse populations. The present study explored patterns of adult role transitions and their associations with substance use and mental health symptoms among young adults using data from Wave 4 of the …

Duration Of Untreated Psychosis (Dup), Treatment Response, And Resting State Functional Connectivity In Antipsychotic-Naïve First-Episode Psychosis Patients, Hillary Patton

All ETDs from UAB

Meta-analyses have found a consistent link between a longer duration of untreated psychosis (DUP) and worse clinical outcomes but the specific pathophysiological processes from a neurobiological level remains unclear. The current study sought to determine the effects of DUP on functional connectivity measured with resting state functional magnetic resonance imaging and evaluated brain network FC as potential mediators in the relationship between DUP and treatment response following antipsychotic drug (APD) treatment. One hundred medication-naïve first- episode psychosis patients underwent a resting state fMRI scan. Signal from brain regions of interest from posterior cingulate (default mode network), anterior cingulate (salience network), …

Racial Discrimination And Inflammation In Adolescence: Ethnic/Racial Processes As Moderators, Queenisha Crichlow

All ETDs from UAB

Discrimination and other psychosocial stressors contribute to chronic disease by dysregulating neuroendocrine and immune systems, which often leads to increased levels of inflammation. Given that inflammation is a key biological pathway associated with the development of chronic diseases, it has been proposed as a potential mechanism linking racial discrimination to poorer health. Most studies linking racial discrimination with inflammation have focused on adults, despite the fact that children and adolescents also experience discrimination. This dissertation explores the association between racial discrimination and inflammation, measured via salivary C-reactive protein (CRP) and proinflammatory cytokines, among Black and Hispanic adolescents. It also examines …

Identifying The Neurobiological Substrates Of Gulf War Illness, Chloe Lisette Jones

All ETDs from UAB

Gulf War Illness (GWI) affects approximately 30% of veterans who served in the 1991 Persian Gulf War and is characterized by chronic pain and fatigue, as well as cognitive, mood, gastrointestinal, and respiratory symptoms. Animal research has suggested that GWI is caused by a combination of neurotoxicants such as nerve gas, anti-nerve agent pills, and pesticides, though a definitive pathophysiological model has not been established. In this human observational study, 20 veterans with GWI and 20 healthy Gulf War veterans (HV) underwent whole-brain magnetic resonance spectroscopy (MRS) to non-invasively measure several metabolites associated with neuroinflammation. Whole blood was also collected …

Myelin Mapping In Psychosis, Victoria Lynn King

All ETDs from UAB

It is well established that myelin in the central nervous system is an axonal insulator which speeds the conduction velocity of action potentials. However, its role in the cortex has also been shown to support metabolic demands and aid in cortical plasticity. Myelin develops throughout childhood and adolescence from sensorimotor areas to association areas and peaks during adolescence. Importantly, this is the same time that psychosis-spectrum disorders (PSDs) begin to present clinically; thus, given the critical role of myelination in shaping the mature cortex, disruptions in this process – particularly during adolescence – are thought to partially explain the onset …

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 …

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 …

The Association Of Resilience Factors With Mental Health Outcomes Among Middle-Aged And Older People Living With Hiv, Jeremy Delgadillo

All ETDs from UAB

Research suggests that people living with HIV (PLWH), an aging chronic health population, have higher prevalence rates and severity of mental health and substance use disorders compared to people living without HIV (PLWoH). Cross-sectional and longitu-dinal studies have suggested intrapersonal resilience factors may serve a protective function in reducing the prevalence and severity of mental health and substance use outcomes among PLWH. The purpose of the current study was two-fold. The first aim was to systematically review the current state of the literature from 2000 to present that examined the associations between intrapersonal resilience factors and mental health outcomes among …

Turn On, Tune In, Drop Shame: Exploring The Unique Therapeutic Potential Of Psychedelics For Sexual And Gender Minority Populations, Nicholas Carlisle

All ETDs from UAB

Sexual and gender minority (SGM) individuals face significant disparities in mental and physical health compared to their heterosexual and cisgender counterparts, due in part to chronic exposure to distal and proximal minority stressors. Shame – a self-focused characterized by a global sense of personal deficiency or unworthiness – has emerged as a key intrapersonal mechanism linking minority stressors to adverse health outcomes. This dissertation explores the role of shame in SGM health inequities and investigates the emerging potential of psychedelics to reduce shame and improve health and wellbeing in these populations. This three-paper dissertation begins with a scoping review (Paper …

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 …

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 …

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 …

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) …

Radio And Television Media And Health-Seeking Behavior Among Women In Rural Northern Nigeria, Olufolake Akeju

Walden Dissertations and Doctoral Studies

Poor maternal health-seeking behavior (MHSB) has contributed to persistently high maternal mortality in rural northern Nigeria. Despite increasing access to health information via media platforms, little is known about the association between media exposure and MHSB in this region. In this study, the association between mass media exposure (radio and television) and MHSB was investigated using institutional delivery as a proxy. The health belief model was applied as the theoretical framework for this study and sought to answer two key questions focused on whether there is an association between media exposure and MHSB in rural northern Nigeria and what the …

Counselors With A History Of Sexual Abuse Who Work With Sexually Violent Offenders, Chandra L. Goodwin

Walden Dissertations and Doctoral Studies

Research on counselors who treat sexually violent offenders has emphasized professional challenges, ethical dilemmas, and vicarious trauma, while less attention has been given to clinicians with personal histories of sexual abuse who may face added strain yet also bring unique empathy and resilience to their work. Addressing this gap is critical for the counseling profession, as it informs how training, supervision, and wellness practices can be structured to better support clinicians with lived trauma histories. This qualitative study explored the lived experiences of counselors with personal histories of sexual abuse who work with sexually violent offenders. Grounded in interpretative phenomenological …

September 11, 2025, James Madison University

The Breeze, 2020-

The Breeze is the student newspaper of James Madison University in Harrisonburg, Virginia.

The Growing Armamentarium Of Image-Guided Tumor Ablation In Interventional Oncology, Ripal Gandhi

All Publications

Minimally invasive image-guided tumor ablation techniques have been established as safe, effective methods to treat a variety of unresectable soft tissue tumors. Standard thermal ablation methods include radiofrequency ablation, microwave ablation, and cryoablation. However, newer non-thermal and/or non-invasive ablation techniques are now available as alternative options to treat soft tissue tumors, particularly those that are near critical structures or otherwise susceptible to thermal energy sink effects. The 4 types of emerging ablation techniques discussed in this review are as follows: irreversible electroporation, pulsed electric field, high-intensity focused ultrasound, and histotripsy. While the clinical trials evaluating the safety and efficacy of …

Human-Centred Supervision: Shaping Future Designers Through Coaching In Final Year Projects, Ina O'Connor, Ceri Almrott

Research Outputs: 2025-Present

Our most significant products require a designer whose understanding of human empathy matches their technical skills; therefore, design education must evolve to reflect this crucial balance. In this context, the supervisor’s role in Product Design final year projects is not just crucial but pivotal in preparing students to meet modern industry challenges. This paper argues that the most effective supervisors act not just as instructors but also as coaches – cheerleaders who push each student to navigate creative challenges, grow personally and professionally and reach their individual potential. The supervisor's influence has a considerable transformative effect, extending beyond the boundaries …

The Influence Of Political Fake News On Tiktok And Its Impact On Inter-Ethnic Relations In Malaysia, Ahmad Luqman Mohd Shamsul Amri, Muhammad Aiman Daniel Mustazar, Muhammad Adib Farhan Mohd Hamim, Mohamad Hafifi Jamri

Jurnal Wacana Politik

TikTok as a platform has become an ideal environment for political discussions and even plays a role in spreading false information. Malaysia, a country with diverse ethnicities, has experienced the impact of viral political misinformation on societal harmony. Thus, this study aims to enhance our understanding of how political misinformation on TikTok can exacerbate ethnic differences in Malaysia by highlighting its potential social implications. The study adopts the Uses and Gratifications Theory as a foundation for developing a framework. A quantitative survey method was employed, with data collected via Google Forms from 407 respondents. Data analysis was conducted using SPSS …

From Model To Behavior: Methodological Challenges In Using Fuzzy Cognitive Maps To Represent Mental Models, Catherine Elizabeth Moore

Dissertations and Theses

This dissertation examines the use of Fuzzy cognitive maps (FCMs) as representations of mental models and how these representations connect to individual behavior. Fuzzy cognitive maps (FCMs) are semi-quantitative models that encode cause-and-effect structures as directed graphs. They are frequently used to represent individuals' knowledge structures/mental models and should in theory correlate to actions and decisions of individuals; however, this correlation has yet to be explored in a systematic manner. This dissertation represents the first step in experimental research on the connection between FCMs and individual behavior. It examines two theories of how humans use mental models, one based on …

Assessing Reliable Change, Mcid, Treatment Response, And Remission Using The Pediatric Anxiety Rating Scale (Pars) In Youth With Anxiety Disorders, Matti Cervin, Philip C Kendall, John C Piacentini, Elizabeth A Gosch, Jeffrey J Wood, Sophie C Schneider, Alison Salloum, Boris Birmaher, Andrew G Guzick, David Mataix-Cols, Eric A Storch

Faculty, Staff and Students Publications

Youth anxiety disorders are common and heterogeneous. The Pediatric Anxiety Rating Scale (PARS) is a clinician-administered tool designed to assess overall anxiety severity, independent of specific symptoms. The thresholds on PARS for the reliable change index (RCI), the minimal clinically important difference (MCID), treatment response, and full and partial remission remain unclear. Using the Clinical Global Impression (CGI) scales and diagnostic interviews as benchmark measures, several thresholds for the 6-item PARS were estimated using data from 904 youth with anxiety disorders, of which 36 % had an autism diagnosis. Data were drawn from 9 clinical trials conducted in the United …

Advice For Improving The Experience Of Web-Based Patient Portals: Qualitative Interviews With Caregiver-Adolescent Dyads, Rachel E Granberg, Jessica M Goldberg, Alison L Antes, Christine Bereitschaft, Fabienne Bourgeois, James Dubois, Bryan A Sisk

2020-Current year OA Pubs

BACKGROUND: Web-based patient portals can benefit adolescents and their caregivers by increasing access and providing greater understanding of one's health information, enhancing communication with clinicians, and supporting caregiver influence. Despite these benefits, adolescent uptake has been low with high attrition rates. Feedback from adolescents and caregivers is essential to improve the uptake and usability of the web-based patient portal.

OBJECTIVE: The aim of the study is to identify advice for medical informatics administrators and clinicians directed at improving the adolescent and caregiver experience with the web-based patient portal.

METHODS: Caregivers completed a demographic survey followed by separate qualitative, semistructured interviews …